SALT LAKE CITY — Two major health care providers in Utah confirmed to KSL TV that they were affected by the security breach, including the University of Utah Health and Intermountain Health pharmacies.
“Those pharmacies that use Change as their change are down 100%,” said pharmacist Jeff Gatzemeier, who sits on the Utah Pharmacy Association Board of Directors and co-owns Oquirrh Mountain Pharmacy.
Gatzemeier said nearly all pharmacies across the state were affected to varying degrees, especially those that serve Medicaid patients.
At Oquirrh Mountain Pharmacy, Gatzemeier and Michelle Speckman, his sister and business partner, said they first noticed problems processing prescriptions for Medicaid patients on Wednesday, Feb. 21.
“…Utah Medicaid started denying claims and saying they weren’t eligible or we couldn’t get the insurance claim paid,” Speckman said. “We didn’t immediately know it was a cyber attack, we thought maybe their computer system just went down.”
Software vendor Change Healthcare, which operates under Optum Solutions as part of the UnitedHealth Group of companies, confirmed the cyber security breach and said it had shut down its systems across the country to “prevent further impact”. Optum provides daily updates, but there is no clear indication of when services will be restored.
According to the Utah Department of Health and Human Services, Utah Medicaid uses Change Healthcare for members whose prescriptions are paid directly by Medicaid (known as fee-for-service).
At the national level
Nationally, a DHHS spokesman said Change Healthcare is one of the main software systems used by health care providers for insurance information and claims processing. According to a spokesperson, Change Healthcare processes one in three patient records in the US.
DHHS issued a statement on Saturday, February 24 advising pharmacies to “provide Medicaid members with a free supply of medications for up to 30 days.”
“We need Medicaid members to get their critical medications,” said Jen Strohecker, Utah Medicaid’s director of counseling. “But we also have to make sure that pharmacies don’t fail.”
“Medicaid has guaranteed to make things right with the pharmacies,” Gatzemeier said.
“Some of it is a bit of blind faith in the hope that we can get paid because we know patients need the medicine.”
“They set up a makeshift system with Utah Medicaid so we can estimate how much money we’re short,” Speckman said.
In addition to Utah Medicaid, University of Utah Health and Intermountain Health also confirmed they were affected by the security breach.
A statement from U of U Health said, “Change Healthcare is a third-party vendor that administers and approves insurance payments for patient prescriptions at a large number of pharmacies across the US, including U of U Health.”
Pharmacies remain open
U of U Health said its pharmacies are still open, but because of the service interruption, they are unable to process insurance claims. Patients are charged full retail price for their prescription, but will be reimbursed by their insurer “when the retailer returns their system.”
For patients who cannot afford the full retail price of their medications, U of U Health said it works with them on a case-by-case basis to provide a shorter supply at a prorated cost.
“We admit that this [paying full retail price] may not be an option for some patients; pharmacy staff are actively working with individual patients to ensure they receive an emergency supply of medication until the system is in place and can process their request for a full supply,” the statement said.
Intermountain Health also confirmed that there was a service interruption.
“We were notified last week that Change Healthcare (owned by Optum) has shut down some of its apps due to a cyber attack. This is a national problem affecting healthcare organizations across the country. Intermountain Health uses some of these applications and we have disconnected our systems with them,” Intermountain Health said in a statement.
‘I’ve never seen anything like this’
However, Intermountain Health did not specify which of its apps were affected or respond to questions about whether their patients’ prescriptions were affected.
While pharmacies have had service outages in the past, Speckman said they usually last a few hours to a day or two.
“I’ve never seen anything like this, that lasts this long,” Speckman said.
Speckman said this is new territory for pharmacists trying to find workarounds and help patients while covering the bottom line.
If patients have trouble getting prescriptions at their regular pharmacy, Speckman encourages them not to go without their medications and to call another pharmacy to see if there are other options.
“There are pharmacies that are helping you and trying to get you medication, although this is certainly a difficult situation,” Speckman said.
Intermountain Health’s full statement:
Last week we were informed that Change Healthcare (owned by Optum) had shut down some of its apps due to a cyber attack. This is a national problem affecting healthcare organizations across the country. Intermountain Health uses some of these applications and we have disconnected our systems from them. Intermountain takes this seriously and communicates with Optum daily to understand and mitigate the impact on its patients and members. A small percentage of pharmacy patients across the country are affected by the app shutdown, but caregivers and pharmacists are working with patients to ensure they get the medications they need. You should contact Change Healthcare for updates.
Full statement from University of Utah Health:
Late last week, UnitedHealth’s Change Healthcare suffered a cyber attack. Change Healthcare is a third-party vendor that manages and approves insurance payments for patient prescriptions at a large number of pharmacies across the US, including U of U Health.
Our pharmacies remain open and pharmacy staff are dedicated to working with patients to provide the best possible care, however, due to this disruption to our service, we are currently unable to process insurance claims.
Like other pharmacies affected by this attack, patients can pay full retail price for prescriptions and receive reimbursement from their insurer after the retailer restores its system. We understand that this may not be an option for some patients; pharmacy staff are actively working with individual patients to ensure they receive an emergency supply of medication until the system is up and running and can process their request for a full supply.
We know this is an inconvenience for patients, but we are committed to ensuring that no patient misses a critical dose of medication and look forward to hearing from Change when systems are back in place.