Skip to Main Content
Skip Nav Destination
Stethoscope on computer

AAP, CHA: Increase financial support and flexibilities, reduce administrative burdens in the wake of Change Healthcare cyberattack

March 20, 2024

Pediatric practices and children’s hospitals need additional financial support and flexibilities and fewer administrative burdens as they grapple with the cyberattack on Change Healthcare, the AAP and Children’s Hospital Association (CHA) said in a letter to federal health officials Wednesday.

“Today, we ask for additional action and to continue your targeted work with states and payers to ensure these flexibilities and supports reach pediatric providers to prevent any further negative impact on children’s access to care,” the groups wrote to U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra, J.D.

Change Healthcare, which is owned by UnitedHealth Group, processes 15 billion health care transactions each year. Since Feb. 21, it has been responding to a cybersecurity issue, taking some systems offline and establishing workarounds.

The attack has impacted pharmacies, claims and payments. It caused delays in verifying patient insurance coverage, prior authorizations and patient billing. It has been especially significant for primary care practices, which often operate on thin financial margins. Some practices have not been paid for weeks and some are spending significant time and money to implement workarounds.

UnitedHealth has advanced more than $2 billion in temporary funding assistance to health care providers. However, the AAP and CHA said not everyone impacted is able to access funding support and for some, it has been inadequate. For example, one practice received an amount less than one-tenth of the impacted claims. Another was offered $10 per week.

“Faced with these major disruptions in revenue, our members are taking out new lines of credit and considering drastic measures like furloughing staff and limiting clinic hours,” the groups wrote to Becerra.

They applauded recent moves by federal officials including recommending flexibility in borrowing and private stock requirements in the Vaccines for Children program, the Centers for Medicare & Medicaid Services urging states to suspend beneficiary cost-sharing and the recent Centers for Medicaid and CHIP Services bulletin outlining state flexibilities in Medicaid.

However, the AAP and CHA said additional flexibilities are needed from Medicaid, the Children’s Health Insurance Program and commercial insurance plans. They urged the following actions.

  • Provide adequate financial support that is easy to understand and access.
  • Waive prior authorization and utilization management requirements. When these can’t be entirely waived, ensure flexibility for providers in timely submission of claims, appeals and prior authorization documentation.
  • Ensure pediatric providers can access relief such as extending reporting periods, waiving documentation requirements, providing general hardship exceptions and other programmatic flexibilities.
  • Ensure patients can access emergency refills and 30-day supplies of medications without additional cost-sharing, including extending in-network benefits for prescriptions filled by out-of-network pharmacies.
  • Offer guidance for tracking and redirecting lab orders that may be impacted by the system disruption and hold providers harmless for delays in making test results available to patients electronically.
  • Dedicate programmatic and financial resources to strengthen cybersecurity to prevent disruptions in the future.

“The nation’s pediatricians and children’s hospitals are striving to ensure children have timely access to the care they need despite the challenges posed by this major system disruption,” the AAP and CHA wrote. “Our organizations stand ready to work with you to support the pediatric health care system.”

About 99% of the pharmacy network services have been restored, according to UnitedHealth. As of March 15, it had restored the electronic payments platform and is proceeding with payer implementation. Monday, it began releasing medical claims preparation software, which will be made available to customers over the next few days. Relay Exchange, the largest clearinghouse, is expected to be back online by the end of the week. Additional phases of reconnection and testing will continue into next week.



Close Modal

or Create an Account

Close Modal
Close Modal