Post-Change hack, hospital pharmacies ask for paused audits

As hospital pharmacies try to recover from a nationwide disruption in their claims and e-prescribing technology, the American Society of Health-System Pharmacists is urging HHS to take action. 

Since Feb. 21, many of Optum's Change Healthcare's applications, including revenue cycle management and prescription processing, have been down. A ransomware attack is complicating operations at hospitals, physician practices and pharmacies, and the issue is expected to last for weeks. 

A few health system pharmacies have cleared the disruption, such as University of Utah Health, which alerted its patients on Feb. 24 that its pharmacies were unable to process most insurance claims. The Salt Lake City-based system told patients to expect longer wait times as its pharmacy staff personally worked with each customer to either offer future reimbursements for full-price purchases or a stop-gap medication supply. 

On Feb. 28, University of Utah Health said it is now able to process insurance claims. 

As other health systems, medical offices and pharmacies work to rebound from the disruption, the ASHP asked HHS to increase communications about the expected recovery timeline and offer regulatory flexibility "related to e-prescribing and 'good faith' estimates of prescription costs."

The ASHP asked for three other responses to the Change Healthcare hack, listed below in the organization's words:

  • Pause audits: Health plans and pharmacy benefit managers should be prohibited from conducting audits or compliance reviews until the cyberattack has been resolved.

  • Make pharmacies whole for good faith dispensing: ASHP is concerned about the uncertainty of receiving reimbursement for a prescription filled in good faith to ensure patient continuity of care and safety. ASHP will continue to work with stakeholders and members on this issue.

  • Address longer-term impacts: Although providers are focused on addressing pressing needs, we must address the long-term impact and the need for a national action plan for responding to future cyberattacks.

The ASHP is directing a letter to HHS from multiple pharmacy organizations "outlining next steps to ensure providers and patients are protected from continued fallout associated with the cyberattack."

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