“A ransomware group once thought to be crippled by law enforcement has disrupted prescription processing for millions of Americans over the past week…” The Washington Post reported .
“The hackers stole patient data, encrypted company files, and demanded money to unlock them, forcing the company to shut down much of its network during recovery efforts.”
Insurance giant UnitedHealthcare Group announced that hackers have attacked its Change Health business unit. Change Health is a business that routes prescription requests from pharmacies to companies that determine whether patients are covered and how much they should pay. Change Health and rival CoverMyMeds are two of the biggest companies. They are players in the so-called switch business, charging pharmacies a small fee to collect claims from insurance companies. “If one of them malfunctions, obviously that's a big problem,” said Patrick Berryman, executive vice president of the National Association of Community Pharmacists.
UnitedHealth estimated that more than 90 percent of the country's more than 70,000 pharmacies will have to change how they process electronic claims as a result of the Change Health outage. However, there are a small number of patients who are unable to obtain prescriptions at any cost. A spokesperson for CVS, which operates one of the nation's largest pharmacy networks, said that due to the outage, “there are a small number of cases in which our pharmacies are unable to process insurance claims.” The company says the workaround has made it possible to fill prescriptions, but…
For pharmacies that were unable to quickly transfer claims to another company, the Change Health outage required pharmacists to manually calculate copays for patients or provide cash prices. Compounding the impact, thousands of organizations have cut Change Health off of their systems to prevent hackers from infecting their networks as well… is in a financial crisis. Companies that deliver drugs without knowing when they will be reimbursed by insurance companies. Some pharmacies ask customers to pay in full if they don't know if a prescription is covered by insurance. In some cases, people are paying more than $1,000 out of pocket, according to social media posts.
Erin Fox, deputy chief pharmacy officer at the University of Utah Health, said the situation is “very confusing.” “In our system, retail pharmacies were providing three days of emergency supplies free of charge for patients who could not afford the cash price,” Fox said in his email. “In some cases, like inhalers, we had to take a risk and send out a product, not knowing if we would get paid, but we need to take care of our patients.” Axis Pharmacy near Seattle Northwest is “dispensing drugs in a frantic manner, never thinking about whether or not they're going to get paid,” said Richard Molitor, the pharmacist in charge.
