Pharmacies across Utah still reeling from a cyber attack on medical software provider

SALT LAKE CITY — Two of Utah’s major healthcare providers confirmed to KSL TV that they were impacted by the security breach including University of Utah Health pharmacies and Intermountain Health.

“Those pharmacies that use Change as their switch have been down 100%,” said pharmacist Jeff Gatzemeier, who sits on the Board of Directors of the Utah Pharmacy Association and is co-owner of Oquirrh Mountain Pharmacy.

Gatzemeier said virtually all pharmacies across the state were affected to varying degrees, especially those serving Medicaid patients.

At Oquirrh Mountain Pharmacy, Gatzemeier and Michelle Speckman, his sister and business partner, said they first noticed issues when processing prescriptions for Medicaid patients on Wednesday, Feb. 21.

“…Utah Medicaid claims started rejecting and saying ineligible or we weren’t able to get a paid claim from the insurance,” Speckman said. “We didn’t know it was a cyber attack right away, we thought maybe their computer system just went down.”

Software provider Change Healthcare, which operates under Optum Solutions as part of the UnitedHealth Group companies, confirmed the cyber security breech and said it shut down its systems across the country to “prevent further impact.” Optum is providing daily updates but there is no clear indication on when services will be restored.

According to the Utah Department of Health and Human Services, Change Healthcare is used by Utah Medicaid for members with prescriptions paid directly by Medicaid (known as fee for service).

At the national level

On a national level, a DHHS spokesperson said Change Healthcare is one of the main software systems used by medical providers for insurance information and to process claims. According to the spokesperson, Change Healthcare handles one in three U.S. patient records.

DHHS issued a statement  advising pharmacies to “provide up to a 30-day supply of medications at no cost to Medicaid members” on Saturday, Feb. 24.

“We need Medicaid members to get their critical medications,” said Jen Strohecker, director of Utah Medicaid in the advisory. “But we also need to make sure pharmacies don’t go out of business.”

“Medicaid has given their assurance that they will make it right with pharmacies,” Gatzemeier said.

“Some of it is a little bit of blind faith hoping we can get paid because we know patients need the medication.”

“They have set up a makeshift system with Utah Medicaid that we can estimate how much money we’re out,” Speckman said.

In addition to Utah Medicaid, University of Utah Health and Intermountain Health also confirmed they were impacted by the security breech.

In a statement U of U Health said, “Change Healthcare is a third-party vendor that manages and authorizes insurance payments for patient prescriptions at a large number of pharmacies throughout the U.S., including U of U Health.”

Pharmacies remain open

U of U Health said its pharmacies remain open however, due to the service disruption, they are not able to process insurance claims. Patients are being charged the full retail price for their prescription but will be reimbursed from their insurer “once the vendor has restored its system.”

For patients who can’t afford the full retail price of their medication, U of U health said it’s working with them on a case-by-case basis to provide a shorter supply at a prorated price point.

“We recognize that this [paying full retail price] may not be an option for some patients; the pharmacy staff is actively working with individual patients to ensure they receive a stop-gap supply of medication until the system is restored and can process their claim for a full supply,” the statement said.

Intermountain Health also confirmed they experienced a disruption in their service.

“We were notified last week that Change Healthcare (owned by Optum) had shut down some of their apps due to a cyberattack. This is a national issue affecting healthcare organizations across the country. Intermountain Health uses some of these apps and we’ve disconnected our systems from them,” the Intermountain Health statement said.

‘Never seen something like this’

However, Intermountain Health did not specify which of its apps were affected or answer questions on whether there is an impact on their patient prescriptions.

While pharmacies have experienced service outages in the past, Speckman said they usually last a few hours to a day or two.

“I have never seen something like this, that lasts this long,” Speckman said.

Speckman said this is new territory for pharmacists who are scrambling to find workarounds and help patients while covering the bottom line.

If patients experience challenges in getting their prescriptions at their regular pharmacy, Speckman encourages them to not go without their medication and call another pharmacy to check for other options.

“There are pharmacies out there who are helping and who are trying to get you your medicine, even though this is a difficult situation for sure,” Speckman said.

Full Statement from Intermountain Health:

We were notified last week that Change Healthcare (owned by Optum) had shut down some of their apps due to a cyberattack. This is a national issue affecting healthcare organizations across the country. Intermountain Health uses some of these apps and we’ve disconnected our systems from them. Intermountain takes this seriously and has been in daily communications with Optum to understand and mitigate the impact to its patients and members. A small percentage of pharmacy patients nationwide are affected by the app shutdown, but caregivers and pharmacists are working with patients to ensure they get the medications they need. You should contact Change Healthcare for updates.

Full statement from University of Utah Health:

Late last week, UnitedHealth’s Change Healthcare experienced a cyber-attack. Change Healthcare is a third-party vendor that manages and authorizes insurance payments for patient prescriptions at a large number of pharmacies throughout the U.S, including U of U Health.

Our pharmacies remain open and the pharmacy staff are committed to working with patients to provide the best care possible, however because of this disruption to our service, we’re not able to process insurance claims at this time.

Like other pharmacies impacted by this attack, patients can pay full retail price for prescriptions and receive reimbursement from their insurer once the vendor has restored its system. We recognize that this may not be an option for some patients; the pharmacy staff is actively working with individual patients to ensure they receive a stop-gap supply of medication until the system is restored and can process their claim for a full supply.

We know this presents an inconvenience for patients but we are committed to ensuring no patient misses a critical dose of medication and we look forward to learning from Change when systems will be restored.