WSHA members, leaders engage with state agencies on Change Healthcare outage

April 17, 2024

Through several meetings with state agencies, WSHA has been able to communicate – both individually and together with members – how deep and long-lasting the Change Healthcare cyberattack has been. WSHA has also reinforced how each hospital has worked through this internally on its own, with, for the most part, very little payer technical assistance or support.

The Health Care Authority (HCA) agreed to expedite any approvals or relief it can provide from fee-for-service Medicaid, as well as encourage its contracted health plans to provide more specific operational support to impacted hospitals to share in some of the administrative burden. The Office of the Insurance Commissioner (OIC) agreed to encourage commercial carriers to do the same and will provide more specific regulatory guidance and potential relief related to any contractual timely filing obligations hospitals may start encountering as they continue to bring systems back online.While most of the initial impact of the Feb. 21 cyberattack was focused on e-prescribing transmissions, the outage also caused several hospitals’ backend operations to come to a halt. A number of Washington hospitals used Change as their primary clearinghouse, which could include claims submission, eligibility verification and/or electronic remittances.

When the outage initially occurred, communication from Change was limited and this forced several hospitals to make quick decisions about how to pivot. Several hospitals permanently or temporarily moved to a new clearinghouse. Moving clearinghouses is a monumental effort in the best of times and doing it in a rushed timeframe required extraordinary reallocation of operational resources.

As these new clearinghouses were coming online, claims still needed to go out manually. Now several members are stuck in a quagmire of duplicate claims, manual remittances and increasing denials for eligibility issues. These are impacts that state agencies like HCA and OIC did not understand when the initial outage occurred.

If you have any additional or new stories/impacts to share, please email Caitlin Safford at caitlins@wsha.org. (Caitlin Safford)

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