UnitedHealth Group indicates that, based on their ongoing investigation, there is no indication that any other UnitedHealth Group systems have been affected by this attack. The company announced the following immediate actions:

Timeline to Restore Change Healthcare Systems

UnitedHealth Group is working on the restoration of their systems and services. Assuming their continued current rate of progress, they expect their key system functionality to be restored and available on the following timelines:

• Pharmacy services: Electronic prescribing is now fully functional with claim submission and payment transmission also available as of today. They have taken action to make sure patients can access their medicines in the meantime, including Optum Rx pharmacies sending members their medications based on the date needed.

• Payments platform: Electronic payment functionality will be available for connection beginning March 15.

• Medical claims: They expect to begin testing and reestablish connectivity to their claims network and software on March 18, restoring service through that week.

While they work to restore these systems, UnitedHealth Group is strongly recommending that their health care professional and payer clients use the applicable workarounds they have established—in particular, using the new iEDI claim submission system in the interest of system redundancy given the current environment.

Continued Funding Support for Community-Based Health Care Professionals

On March 1, Optum launched a Temporary Funding Assistance Program to help bridge the gap in short-term cash flow needs for health care professionals who received payments from payers that were processed by Change Healthcare.

UnitedHealthcare will provide further funding solutions for its health care professional partners. This applies to medical, dental, and vision health care professionals and will involve advancing funds each week representing the difference between their historical payment levels and the payment levels post attack. Advances will not need to be repaid until claims flows have fully resumed. Health care professionals must complete a one-time registration to access funding.

UnitedHealth Group urged all payers to do the same as this is the fastest, most efficient way to address health care professional short-term cash flow needs. UnitedHealthcare does not have visibility to the extent of business interruption for each health care professional; therefore, it is necessary for other payers to participate in a similar manner. 

They recognize these programs will not work for everyone. Beyond UnitedHealthcare’s provider funding relief, Optum is expanding its funding program to include health care professionals who have exhausted all available connection options, and who work with a payer who has opted not to advance funds to health care professionals during the period when Change Healthcare systems remain down.

This expansion is a funding mechanism of last resort, especially for small and regional health care professionals, and will be evaluated on a case-by-case basis. An Optum Pay account is required to complete registration and to receive funds and repay funds. Use your existing Optum Pay account or sign up for Optum Pay to login.

For those who receive funding support, there are no fees, interest or other associated costs with the assistance. For repayment, health care professionals will receive an invoice once standard payment operations resume and will have 30 days to return the funds. These terms now apply to both the original and expanded funding programs.

To determine eligibility and funding amount, please register for the program at the website: www.optum.com/temporaryfunding.

Additional Consumer Actions

For Medicare Advantage plans, including Dual Special Needs Plans, UnitedHealth Group is temporarily suspending prior authorizations for most outpatient services except for Durable Medical Equipment, cosmetic procedures, and Part B step therapies. They also are temporarily suspending utilization review for MA inpatient admissions.

For Medicare Part D pharmacy benefits, they are temporarily suspending drug formulary exception review processes.

These actions will remain in place until March 31. They will work with state Medicaid agencies on any actions they wish to implement.

Prescription Support

As of today, all major pharmacy claims and payment systems are back up and functioning. They have taken action to make sure patients can access their medicines in the meantime, including Optum Rx pharmacies sending members their medications based on the date needed.

Additionally, recognizing that they were asking pharmacies to take action to help patients, Optum Rx PBM notified network pharmacy partners and pharmacy associations that they would reimburse all appropriate pharmacy claims filled with the good faith understanding that a medication would be covered. They continue to focus on those remaining areas of pharmacy disruption, including specialty coupon programs and certain claims for infusion providers.

For more information and access to all solutions provided by UnitedHealth Group, visit http://www.uhg.com/changehealthcarecyberresponse.

The company expects to exclude the principal impacts arising as a result of the cyberattack from adjusted earnings. Read the UnitedHealth Group press release dated March 7, 2024.