Cyberattack straining US health care system
Arlington Health leader says patient care in nation will suffer if problem lingers Ransomware hack cripples digital clearinghouse for medical bills
Molly Fulton, chief operating officer of Arlington Health, which operates five urgent care clinics across central Ohio, hasn’t been able to bill patients for her services for over two weeks.
Arlington Health first started noticing problems on Feb. 21, when employees couldn’t check patient insurance eligibility. Then, by the second day, Fulton said Arlington Health noticed they couldn’t submit claims for insurance payment. Now Fulton is warning that the financial situation could become dire as income dries up.
“I’m worried, I’m not panicking. I am confident in the business we have built,” Fulton said. “We can function adequately, still provide fantastic patient care for a couple of months before things start to get scary for us.”
Arlington Health, which has urgent care clinics in Upper Arlington, Bexley, Washington Courthouse, Delaware and Worthington is just one health care provider among thousands of hospital systems, doctor’s offices and urgent care clinics unable to submit bills for many of their patients.
On Feb. 21, Change Healthcare, a property of Unitedhealth Group, announced that a ransomware group known as ALPHV or Blackcath had disrupted operations for the company that processes 15 billion health-related transactions a year, USA TODAY reported.
Change Healthcare operates the nation’s largest digital “clearinghouse” that connects doctors, hospitals and other health providers with insurance companies that pay for medical care and authorize medical services, USA TODAY reported. Since news of the hack became public last month, doctors and hospitals have been unable to bill for some services and patients have had trouble picking up prescriptions.
And on Tuesday, The U.S. Department of Health and Human Services asked insurers to waive prior authorizations and Medicare’s contractors to accept paper bills from doctors and hospitals.
However, Eric Drobny, president of the Ohio State Medical Association and emergency room doctor who operates an ER practice, said filing paper bills is not a proper workaround and takes valuable time and labor away from patient care.
“I’m worried, I’m not panicking. I am confident in the business we have built.” Molly Fulton Chief operating officer of Arlington Health
“Imagine like a merchant who takes credit card payments, all of a sudden has to submit an invoice (for each purchase),” Drobny said. “It’s just it’s not going to work.”
Risk ‘scarier than even COVID was’ for health care industry
Fulton said patient care will suffer across the country the longer the problem lingers. While many medical practices closed during the COVID-19 pandemic, this is more threatening in some ways to the industry, she said.
“This is actually a little bit scarier for me and my counterparts in the industry than even COVID was, because it’s that big of an impact on on our on our day-today operation,” Fulton said. “Like any business, we are eventually going to have to start making some decisions and prioritizing where we spend our money and what we spend our money on.”
Drobny said some health care businesses may not even understand the gravity of the financial situation because they are still receiving payments on invoices from a month ago. That’s why the medical association is trying to keep providers up-to-date with information about the hacks.
While there haven’t been patient care problems yet, he said he can see a situation if the problem persists where patients have their appointments canceled or cannot get a prescription and then find themselves in an emergency room with a medical emergency.
“This may be twofold: when the initial hit and a delayed hit,” Drobny said. “Four weeks after the initial problem, people’s cash flow starts to dry up.”
Fulton said Arlington Health can survive if the billing issues continue to persist but she is worried that other “mom and pop” urgent care offices may be forced to make challenging decisions about reducing staffing or closing in the comings days or weeks.
“There’s about 14,000, urgent care centers in the nation and, and if even a fraction of those go under because of this issue, it’s going to put an enormous strain on the emergency departments and the health care infrastructure as a whole,” Fulton said.
Drobny said the OSMA is hoping this situation will be a wake-up call for the health care industry, and the dangers of consolidating health care systems and clearinghouses.
“The ripple effect is huge,” Drobny said of industry consolidation. “And the power they consolidate, and it’s been taken out of the provider’s hands.”