UnitedHealth CEO Called to Testify in Congress Today

[sent]

Change Healthcare, a claims processing company for medical, hospitals, pharmacies, dental, etc. was hacked on Feb. 22, 2024. This affected pharmacies in the US immediately as they couldn't look up benefits for their patients. All other healthcare practices were affected right after as insurance claims couldn't be process and many insurance companies stopped sending payments for services that were already completed. This hasn't really been reported in the mainstream news very much. I couldn't find any mention of the CEO going to Congress today when I looked on the main page of CNN. It has been over 2 months and these issues have still not been fully resolved. I know doctors who are just now getting back payments from GEHA, an insurance company. That's just 1 example, there are many issues still lingering and I don't even know if the main issues have even been fixed because I have used a different claims processor from the beginning. 

Change Healthcare was bought by UnitedHealth a few years ago in their quest for vertical integration. The article talks about how hospitals and doctor's offices were not getting paid and couldn't meet payroll and other financial obligations. Many doctors reached into their own savings to keep things going because asking UnitedHealth for help was going nowhere. 

For a company that posted $22 Billion in profits last year, there doesn't seem to be any good reason why this wasn't addressed and fixed immediately. Congress has called the CEO because this is a national security issue. The breach happened through an overseas user, not a user in the US. Millions of Americans have their medical info in the hands of hackers somewhere on the other side of the world. UnitedHealth paid the hackers $22 million in late March. One of the comments mentioned that the hack happened because UnitedHealth bought Change Healthcare so the hackers know that a top 5 American company is so large that it can afford a ransom. ChangeHealthcare when it was its own entity was probably not as attractive of a target because it was small. 

This article was eye opening. Not related to this hack, the article discussed how a provision was put in the ACA requiring insurance companies to spend 85% of their revenues on patient care. This led to the current mess where insurance companies have been racing to buy up private medical practices in our communities to specifically get around this rule. That has led to these companies growing bigger and bigger. I have been feeling really down lately that insurance is such a mess for many reasons since I am in the healthcare world and I try to run a private practice so I am very keen to see what happens now that the government is finally getting involved (fingers crossed).

www.washingtonpost.com/health/2024/04/30/unitedhealth-congress-review-cyberattack/

(sorry I can't post a free link, I read the article through Reddit)

[picksthemusic]

Optum (UnitedHealth) bought the clinic I worked for before I came to public health, and basically ruined it. They did layoffs and started outsourcing work we had previously done in-house. I hate UH and Optum and the whole conglomerate, for-profit healthcare. I hope this spurs change.

[picksthemusic]

Here's a gift link for those who want to read it:

wapo.st/3UHcmyD

[dish2501]

I worked for Change Healthcare during the acquisition process and got out before it closed. CHC has many arms and I was not on the clearinghouse side. Optum did massive layoffs once the deal closed. I wonder if some key staff was let go.

The DOJ took a long time to approve the acquisition. I hope they are also looking more closely at future mergers.


I saw UHC paid a $22M ransom to release the hack but the impact to customers and patients is still unknown. I’m really surprised about how the hackers got in (no MFA). Everything seems to have MFA now.

[sent]

May 3, 2024 9:48:47 GMT -5 dish2501 said:

I worked for Change Healthcare during the acquisition process and got out before it closed. CHC has many arms and I was not on the clearinghouse side. Optum did massive layoffs once the deal closed. I wonder if some key staff was let go.

The DOJ took a long time to approve the acquisition. I hope they are also looking more closely at future mergers.


I saw UHC paid a $22M ransom to release the hack but the impact to customers and patients is still unknown. I’m really surprised about how the hackers got in (no MFA). Everything seems to have MFA now.

On the dental side, I know doctors have still not been paid from patients who have GEHA as their dental insurance. Many are now asking patients with that insurance to pay upfront or put off care because how long can you realistically wait for multibillion dollar companies to get their act together while you are trying to pay your bills down on Main Street? GEHA apparently sent out their first round of payments since the hack just last week and they sent them out as VCCs***, like they couldn't be more tone deaf. Offices that bill patients with Guardian dental insurance have seen payments trickling in very slowly. I don't have many patients with these plans so I have not personally been too impacted. I'm sure the effects on the medical side have been much worse. 

I think I read that there was not MFA on the international user's access that the hackers used. It's been hard to read meaningful news on this subject, almost like the company doesn't want this news out there...

***VCCs are another topic that makes my jaw drop. How did 1 person manage to convince the Center for Medicare and Medicaid that this was THE way to go to reimburse doctors and then a bunch of middle men swoop in and profit for messing with a system that didn't need fixing? Stories like this make me love Propublica and the work they do. It also makes me wonder that if it takes only one person to create such an enormous negative financial impact on the way doctors & hospitals get paid, then how can I help that one person who can use their influence to create some positive change in this horrible healthcare mess. The Hidden Fee Costing Doctors Millions Every Year

[ellipses84]

I can’t remember which book it was but there were examples of healthcare companies being taken over by private equity and how disastrous it was to good healthcare and the employees. I think it was These are the Plunderers, although it may have been mentioned in The Sum of Us and Poverty by America (and maybe all 3).

[livinitup]

Today, my cousin picked up a monthly Rx that usually cost her $45 as a co-pay. Nothing changed this month - same insurance, same Rx, everything except the co-pay was over $100. So, she asked the pharmacist about why the increase? The pharmacist said the manufacturer of the medicine was purchased by another company. So, my cousin looked at her paperwork history. The same one-month med was charged last month (and every month before last month) at $800./month. The new company charged the insurance company $4K/month.

$4K. Just like that.

[sent]

May 3, 2024 22:46:39 GMT -5 livinitup said:

Today, my cousin picked up a monthly Rx that usually cost her $45 as a co-pay. Nothing changed this month - same insurance, same Rx, everything except the co-pay was over $100. So, she asked the pharmacist about why the increase? The pharmacist said the manufacturer of the medicine was purchased by another company. So, my cousin looked at her paperwork history. The same one-month med was charged last month (and every month before last month) at $800./month. The new company charged the insurance company $4K/month.

$4K. Just like that.

I don't think that means the insurance company will automatically pay the new company $4K. But there is probably weird math involved by billing the $4K to get the insurance company to pay more than whatever the last company was being paid by the insurance company. 

I could be wrong about this. I would like to learn more and I read whatever can I find on insurance billing & reimbursements. It's such an enormous mystery.