PHOENIX — A cyberattack that battered the U.S. health care payment processing industry last month is continuing to cause havoc. As state leaders seek to assure the public they are diligently working on workaround solutions, some doctors and surgeons in Arizona said they will struggle to remain open in the coming weeks if they don’t get paid by insurers.
“It’s been catastrophic,” said Dr. Tristan Pico, who runs seven pain centers around the Valley.
Pico relies heavily on Medicaid payments. The cyberattack resulted in complications for Medicaid and some insurance companies to pay pharmacies and other medical providers. Pharmacies, Cancer centers and family practices nationwide have reported similar problems.
Pico says payments from the state’s Medicaid provider, AHCCCS, ceased on Jan. 21.
“Paying for bills and my staff, it’s all being paid with my personal funds at this point,” Pico said. “Eventually if we’re not paying these employees, they’re going to have to go somewhere else.”
Some medical practices have 'very small profit margin'
Wendy Bruno Thomson runs a company that advises health care providers nationwide, including nearly 100 in Arizona. Thomson says about 75% of her Arizona clients are not getting their requests for emergency payment fulfilled by the state.
“This is really critical,” Thomson said. “These individuals and medical practices, they have a very small profit margin to keep their lights on.”
Thomson says it is a misconception that medical practices are flush with cash. Heading into this year, many of her providers were already strained, facing lower reimbursements and higher costs for labor and supplies. Many providers have just a month of financial cushion.
“This is really serious. Yesterday I came into several notes from physicians saying ‘I don’t know what I’m going to do for payroll this week’,” Thomson said.
State AHCCCS leaders working 'as quickly as possible'
In response to the attack, leaders of the state’s AHCCCS system set up a process to provide emergency funds to health care providers.
Those payments largely rely on middleman contractors. Seven managed care organizations facilitate payments for most enrolled Medicaid members in Arizona.
A spokesperson for AHCCCS says they are looking into Thomson’s claims and they are aware of the impact the computer hack has on the system.
“We are actively working the situation each day to ameliorate those impacts,” said Heidi Capriotti, communication administrator. Capriotti said AHCCCS is vetting and reviewing payment requests larger than $50K.
“To date, AHCCCS has reviewed more than 120 individual requests; we have allocated as many resources as possible to working this issue and are assessing each request as quickly as possible,” Capriotti said.
Read the full statement from AHCCCS:
AHCCCS recognizes and acknowledges the impact the Change Healthcare security incident has had on Arizona’s providers and we are actively working the situation each day to ameliorate those impacts.
We have directed our contracted managed care health plans to implement their Continuity of Operations plans as appropriate and to ensure work-around processes are in place to support timely and appropriate access to care, which may include but are not limited to: manual processing methods, medication overrides, non-emergency medical transportation coordination, and more.
We’ve asked providers who are contracted with managed care health plans to contact their health plans with requests for emergency funding. Requests greater than $50k are vetted and approved by AHCCCS after operational and financial review; these requests are reviewed and responded to within one working day of receipt. To date, AHCCCS has reviewed more than 120 individual requests; we have allocated as many resources as possible to working this issue and are assessing each request as quickly as possible.
Additionally, AHCCCS is in regular communication with the State’s Emergency Operations Center to coordinate response efforts, the Centers for Medicare and Medicaid Services (CMS), and all state Medicaid agencies as we address the national impacts of this ongoing situation.
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