The American Medical Association is urging Optum to stop its approach for recouping Change Healthcare cyberattack-related loans and to suspend all claim filing deadlines associated with the resulting outage.
The AMA is hearing from many practices about Optum's "strict measures" related to repayment of loans after the 2024 cyberattack shut down Change's claim processing business, according to an April 11 letter from AMA Executive Vice President and CEO Dr. James L. Madara to OptumInsight CEO Roger Connor. UnitedHealth Group CEO Andrew Witty is cc'd on the letter.
After the Feb. 21, 2024, ransomware attack, healthcare providers were told to disconnect from Optum, which owns Change. Due to the disruption in claims, Change parent company Optum offered providers loans to help offset the lack of payment.
"In addition," Madara wrote, "many practices are still grappling with claims from the period associated with CHC's (Change Healthcare's) outage and receiving rejections for not meeting UnitedHealthcare's timely filing deadlines."
AMA members are reporting that "Optum has instituted a loan repayment process that unexpectedly calls for immediate repayment of sizable loans – sometimes amounting to hundreds of thousands of dollars," Madara said.
Practices that don't repay within five business days are threatened to have their practices' claims payments withheld until the balance is repaid, he said.
WHY THIS MATTERS
The AMA is asking for two remedies.
One is to use an individualized practice-by-practice approach for recouping Change cyberattack-related loans.
The other is to work with UnitedHealthcare to suspend all claim filing deadlines associated with the time period when Change's systems were non-functional and practices were unable to file claims.
"Physician practices are still suffering severe financial distress as a result of the cyberattack nearly 14 months after the breach was first discovered," Madara said. "To be clear, physicians and other medical providers did nothing wrong and were compliant with industry standards and regulations; they did not suffer any data breach of their systems but were powerless to prevent the widespread service outage caused by the failure of CHC to secure its data and keep its systems operational."
THE LARGER TREND
UnitedHealth Group's Witty testified before the Senate Finance Committee in May 2024 that he had no intention of asking for loan repayment until the physician determines that business is back to normal, the letter said. Even when business is back to normal, the company would not look for repayment for 45 business days after that. No interest or fees would apply to the loan.
The AMA said that since physician practice recovery is still in process, business is not back to normal.
ON THE RECORD
"We want Optum to honor its commitment to wait to recover repayment for any loans until the physician determines that it is the appropriate time, because the physicians have relied on Optum's statements," Madara said. "We also ask Optum, rather than pursuing a 'one-size-fits-all' approach to loan repayment, to instead reach out to each practice that received a loan to negotiate an individualized, realistic repayment plan that is appropriate to that practice."
Email the writer: SMorse@himss.org