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UnitedHealth's headquarters in Minnetonka, Minnesota. (Photo: UnitedHealth)

Life Health > Health Insurance > Medicare Planning

U.S. Tells Health Insurers to Relax Rules After Hack Cripples Approvals Network

By John Tozzi

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U.S. health regulators urged insurers that administer government health plans to suspend some limits on care after a crippling cyberattack brought down networks that handle approval requests.

Private versions of Medicare and Medicaid should relax mandates for prior authorizations and other hurdles that can keep people from getting care, the U.S. Department of Health and Human Services said Tuesday in a statement.

The move is the latest impact of a far-reaching hack that brought down UnitedHealth Group’s Change Healthcare unit almost two weeks ago. The unit runs crucial networks that move data and payments throughout the health-care system, and the attack has meant growing backlogs throughout the industry, including delays at pharmacies and late payments for doctors.

UnitedHealth hasn’t said when most of the network’s services will be back online. HHS aims “to help coordinate efforts to avoid disruptions to care throughout the health care system,” the agency said in a news release.

Many health plans, particularly private versions of Medicare and Medicaid, require permission in advance for certain procedures, hospital admissions or medications. The requests, known as prior authorizations, are already considered burdensome by doctors and patients and have become even more challenging with Change’s networks down.

Lifting the rules could speed access to care for patients. It would also add more uncertainty for insurers that have a harder time gauging their expenses because of the hack’s disruption.

Since some systems to submit claims and receive payments are down, hospitals, pharmacies and other providers have alerted regulators to risks of cash-flow interruptions. The agency is offering assistance to help doctors switch their billing systems to other networks that are still online. HHS also said hospitals can seek accelerated Medicare payments from the contractors that manage those transactions.

Credit: UnitedHealth

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