Lance's Corner

NYSAG Joins Coalition Urging Change Healthcare to Help Providers and Patients Harmed by Cyberattack

Apr 29, 2024

Per the notice below, the New York State Attorney General (NYSAG) has joined a multistate coalition urging Change Healthcare to help patients and health care providers harmed by the cyberattack that Change Healthcare suffered.

Attorney General James Urges UnitedHealth Group to Help Patients and Providers Harmed by Cyberattack

Cyberattack on Change Healthcare’s Systems in February Affected Millions of Patients and Providers Nationwide, Disrupting Access to Care and Payments to Health Care Facilities

New York Attorney General Letitia James joined a multistate, bipartisan coalition of 22 attorneys general in urging UnitedHealth Group, Inc. (United), the nation’s largest health insurer, to better protect patients, providers, and pharmacies harmed by the recent cyberattack on its subsidiary, Change Healthcare.  Following the cyberattack on Change Healthcare in February 2024 that disrupted health care providers’ networks, patients have reported delays in access to care, have been denied access to prescription drugs, and have had difficulty scheduling appointments or procedures.  Millions of New Yorkers have been affected by this cyberattack and providers have been unable to process insurance claims, causing financial harm for providers in New York and across the country.  Attorney General James and the bipartisan coalition are calling on United to improve transparency about the cyberattack, quickly resolve the backlog of claims, and take more steps to protect patient data.

“Patients and health care providers nationwide should not have to suffer because of UnitedHealth’s failures,” said Attorney General James.  “Scheduling a medical procedure can already be worrisome, and now the delays and disruptions caused by this cyberattack have made accessing care much harder for patients.  UnitedHealth has an obligation to protect its patients and must do more to minimize the harm of the cyberattack on its systems.  I am proud to stand with a bipartisan coalition of attorneys general in urging UnitedHealth to take action and fix this problem.”

Change Healthcare, which was acquired by United in 2022, runs the nation’s biggest electronic health care payment system.  Its technological infrastructure is used by tens of thousands of providers, pharmacies, and insurers to verify insurance, confirm pre-authorization of procedures or services, exchange insurance claims data, and perform other administrative tasks essential to the delivery of health care.  In February 2024, Change Healthcare experienced a cyberattack by a cybercriminal group called ALPHV/Blackcat, which crippled its platform.  Since the cyberattack, providers, pharmacies, and health care facilities nationwide have reported catastrophic disruptions, and have been unable to verify insurance coverage, obtain prior authorization for health care services, process claims, or obtain reimbursements for patients.  In the letter, Attorney General James and the bipartisan coalition call upon UnitedHealth Group to act quickly to limit the harm to the states’ health care providers and patients.  Specifically, the coalition asks UnitedHealth Group to take the following steps:

  • Enhance and expand financial assistance, free of onerous terms, to all affected providers, facilities, and pharmacies.
  • Ensure financial assistance programs are not providing more advantageous financial assistance to providers, practices, or facilities that are owned by UnitedHealth Group.
  • Shield the business information of providers and pharmacies from United’s other corporate lines of business.
  • Suspend requirements for prior authorizations, contemporaneous notifications of change of status, and other documentation requirements.
  • Provide a dedicated help line for providers, facilities, pharmacies, and state attorneys general.
  • Proactively inform providers, facilities, pharmacies, and industry groups associated with each, of the steps they can take to preserve claims and receive prompt reimbursement.
  • Expeditiously resolve the claims backlog and ensure prompt reimbursement of claims.
  • Ensure providers, facilities, pharmacies, regulators, affected patients, and the public are informed of what data was compromised and what steps, if any, are needed for providers and patients to mitigate future identity theft or systems risks.

Joining Attorney General James in the letter to UnitedHealth Group are the attorneys general of Arizona, California, Connecticut, Hawaii, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Nebraska, Nevada, New Hampshire, North Carolina, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Washington, and the District of Columbia.

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc