Change after Change

When Change Healthcare acknowledged that it had been hacked by a “threat actor” named “BlackCat” and subsequently had to disconnect its systems, we were fairly certain it would be the subject of the cartoon and HME Newspoll for the April issue. 

There were other ideas, of course – Theresa and I are nothing but a font of content, are we not? – including a poll on the impact on the HME industry of Dexcom’s plans to offer a continuous glucose monitoring device over the counter. 

But this cyberattack was too big and too serious to ignore. 

So much so, that in the span of days, CMS announced flexibilities to make it easier for providers to switch to a different clearinghouse, and then – on a Saturday no less – it announced plans to make available accelerated payments to Part A providers and advanced payments to Part B providers. Medicare Administrative Contractors like CGS subsequently published templates that providers can use to submit for those payments. 

For its part, Change Healthcare expected to begin testing and reestablishing connectivity to its claims network and software on March 18 and to restore service through that week. It expected its electronic payment functionality to be available for connection beginning March 15.  

Even if all that goes according to plan, the outage will have lasted nearly a month – an eternity in today’s day and age.      

A cartoon featuring a black cat won out. It’s a devious cat with sharp nails, wreaking havoc on the health care system – every large hospital to physician practice to pharmacy to HME company and every provider in between. 

And, of course, that had serious trickle-down effects. People like my mother, trying to fill a prescription for my father, got tangled in the outage. The pharmacy told her they had no way of billing for the prescription, so she would have to pay out of pocket more than $600 for a drug that typically costs $7 or wait until the issue was resolved. 

Because health care is so increasingly complicated (UnitedHealthcare owns Optum which owns Change Healthcare which owns other health IT companies), analogies explaining the impact of the outage were abundant. Steve Cela at Strategic Office Support likened the company to a Visa or Mastercard in describing its essentialness to the HME billing workflow. I also heard someone describe the company as a superhighway for claims – to which Theresa aptly pointed would be another great idea for a cartoon. “They landed in the breakdown lane,” she dead panned. 

I also heard someone liken Change Healthcare to a pharmacy benefit manager. In other words, a company that smarter people than me invented the need for, but in reality, may not be needed and may only complicate the health care system further; create, some would argue, unfair practices; and, apparently, make it wicked vulnerable. 

They say black cats are bad luck and, in this case, that’s certainly been the case, but we’ll be watching to see what kind of changes are made in the aftermath of the outage. Software companies are touting the importance of redundancy in clearinghouses, for one, which is all and well and good. 

But when your alternative to Change Healthcare is another clearinghouse owned by a large insurer – like Availity which owns other health IT companies and which is part of Health Care Services Corporation which is buying Cigna’s Medicare business – we have to do better than that.