Members of Congress on Both Sides of the Aisle Call for Accountability from UnitedHealth as Patients & Providers Try to Recover from Attack
On Wednesday, the U.S. Senate Finance Committee and U.S. House Energy and Commerce Oversight and Investigations Subcommittee held a pair of hearings questioning UnitedHealth Group CEO Andrew Witty on the fallout from the Change Healthcare cyberattack and the company’s insufficient response.
The proceedings made clear the broad, bipartisan concern and frustration surrounding both UnitedHealth’s response to the cyberattack and a number of its broader corporate practices. Lawmakers from across the spectrum called on the giant corporate insurer to take ownership and responsibility for the harm they have caused to both patients and providers.
Here is what members had to say during the hearings on the impact to patients:
Subcommittee Chairman Morgan Griffith (R-VA-09): “I’m concerned about patients who have been affected. Many patients were left having to pay large amounts of money out of pocket for their medications because the pharmacy couldn’t process their claims or their copay coupons….United is contractually obligated to pay for these medications, yet patients are still paying premiums and forced to either walk away, pay large sums of money for their medications, or even having to borrow money from friends, family, or worse, interest-bearing cash advances off their credit cards… Providers were also deeply affected by this cyberattack. In the initial phase, providers were left in the dark as to why United stopped processing claims. There was deep uncertainty about how to get their claims to flow uninterrupted, the loan program was minimal and restrictive, while bringing on many unrecognized expenses for the providers such as switching clearinghouses and managing prior authorization. It’s particularly troublesome because doctors are worried about keeping their practices open.”
Committee Ranking Member Frank Pallone (D-NJ-06): “As a result of this attack, healthcare providers have experienced tremendous delays in reimbursement, patients have been forced to either front out-of-pocket expenses for their medicine or had to delay treatment because pharmacies have been unable to process claims…the delayed restoration and lack of communication from UnitedHealth Group about a central part of our healthcare system is unacceptable…It’s wrong that healthcare providers, pharmacies and patients continue to bear the brunt of a failure by a corporation that earned $371 billion to either prevent or quickly remedy this situation.”
Here is what members had to say during the hearings on the impact to providers:
U.S. Senator John Barrasso (R-WY): “Rural hospitals all across Wyoming and the US provide access to essential health services. You know they represent the most financially vulnerable hospitals because when a hospital closes it’s usually a rural hospital. So 50% of rural hospitals are already operating right now in the red. This breach may send some of them into a financial spiral for which they can’t come back, and those communities are often rural frontier areas. There’s not a hospital, another hospital nearby…. We want to make sure you’re specifically prioritizing these rural and financially vulnerable hospitals because they need to keep their doors open and they’re the only source of supply.”
U.S. Senator Michael Bennet (D-CO): “This is obviously affecting cash flows all across the state. We’ve got patients in Colorado that that are continuing to need care and since the hack my office has been working with offices all over the state. They’re still two or three months away from their normal cash flow and they’re already as you know operating on a shoestring as this is, so on top of what they’re dealing with normal reimbursement processes have yet to come back online… This single attack has kicked off a cascading series of crises that are unmasking some deep vulnerabilities in the core of our healthcare system, and Colorado practices and hospitals have been left to pick up the pieces covering the costs of someone else’s cybersecurity failure.”
U.S. Senator Marsha Blackburn (R-TN): “We have, and here’s a good for instance for you, a small independent private act hospital in West Tennessee. And they have diligently submitted all of their claims, and they are burdened with the backlog of Medicare claims that is equivalent to 30 days of revenue. And they’re waiting for these things to be transmitted to Medicare. And this is all because of the missteps that you all have had… Optum, because it’s widely acknowledged that Optum’s temporary assistance program fails to adequately address the financial setbacks that are caused by this. Now, we’ve got one Tennessee provider that disclosed receiving a one-time payment of $8,000 significantly below their usual daily revenue of $20,000. And these providers have resorted to tapping into personal savings, retirement funds, seeking loans from banks.”
U.S. Senator Bob Casey (D-PA): “In public statements, UnitedHealthcare claims that the vast majority of services has been restored to pre-cyber-attack levels. You spoke about the company’s efforts to make providers whole. I continue to hear, however, from providers in Pennsylvania who are struggling to serve their patients as they await reimbursement for the care they’re providing.”
U.S. Senator Catherine Cortez Masto (D-NV): “I am concerned about the lasting effects of UnitedHealthcare Group’s cybersecurity failure on the health sector. Providers that I am hearing from have faced dramatic drops in revenue and are missing out on interest from delayed payments… In Nevada, one health center reports spending $12,000 every week on overtime for staff who are dealing with the billing and eligibility issues caused by this Change Healthcare outage. For many small providers in my state, missing just two payments could force their foreclosure.”
U.S. Representative Mariannette Miller-Meeks (R-IA-01): “According to data from the American Medical Association, 80 percent of practices reported lost revenue from unpaid claims and 85 percent stated they had to allocate additional staff time to complete additional administrative requirements. And we already have that burden. I’m a small business practitioner coming to Congress and neither doctors nor their non-physician staff will receive any additional compensation for time spent mitigating the fallout of the Change attack, just like we’re not compensated for the hours in prior authorization time that we have to expend on denials of claims that are then found to be valid. And this is on top of the administrative and financial burden that American physicians and healthcare workforce are already experiencing. In Iowa, doctors are very hesitant to take advanced payment dollars without confirmation that their claims submissions will be paid at the rate submitted and are concerned that they will be required to pay back more than what ultimately will be approved for payment once the backlog processing is completed.”
U.S. Representative Kim Schrier (D-WA-08): “The reality is that this massive, far-reaching attack has disproportionally impacted small independent practices that were already struggling to stay afloat. United’s advanced payments have been appreciated but insufficient. Other payers, as you’ve just heard, have done nothing to help. It is in their interest to hold onto that money. I’ll give you an example—Balance Physical Therapy is a private practice in Washington that employs just six physical therapists. The Change attack has devasted them to the point where the owners had to mortgage their home in order to pay rent and make payroll. Now that money has run out. Mr. Witty, your company reported $371 billion dollars in revenue last year. Do you want to hazard a guess as to how much Balance Physical Therapy was paid in the first round?…$70…You should be able to do better than that…One question for you is to make this right, it would be great to help repay the mortgaged home. Will you help with things like that make these companies whole?”
Here is what members had to say during the hearings on UnitedHealth’s industry “monopoly” and its impact on patients and providers:
Chairman Ron Wyden (D-OR): “You know, our physicians are very much at risk. They owe you for these loans, and I’m concerned that these loans are going to give you valuable financial information that, based on the company’s history, is going to be used to gobble up lots of other small providers across the country…this is not a hypothetical question for your company, because your company is buying these people up hand over fist… And in much of what I’ve read about this, you’re kind of saying to the American people, you should feel lucky that we’re big. I think that a lot of Americans today don’t buy that. And I think that your company, on your watch, let the country down and these millions of people on both the prevention side… and on getting us back and going.”
U.S. Senator Elizabeth Warren (D-MA): “UnitedHealth Group owns the country’s largest insurer, the country’s largest claims processor, the country’s third largest pharmacy benefit manager, a huge pharmacy chain. It is the largest employer of physicians nationwide—or controller—with at least 90,000 physicians, as you just testified. That’s about one out of every ten doctors in the country… Because UnitedHealth has bought up every link in the healthcare chain, you are now in a position to jack up prices, squeeze competitors, hide revenues, and pressure doctors to put profits ahead of patients…After the largest cyberattack on the healthcare industry in American history, quote, ‘put hundreds of thousands of healthcare providers at risk of collapse,’ UnitedHealth is now using the crisis to expand its monopoly even further.”
Watch the full U.S. Senate Finance Committee hearing HERE and the U.S. House Energy and Commerce Subcommittee on Oversight and Regulation hearing HERE.