Vermont’s Medicaid pharmacy claims system is back online following an unprecedented cyberattack on the company that runs it, according to the Department of Vermont Health Access.
Medicaid pharmacy claims began flowing again on Monday after a Feb. 21 cyberattack on Change Health, which operates Vermont’s Medicaid pharmacy claims system, the department announced in a Monday press release. The cyberattack caused the private company to take its systems offline for nearly a month.
Alex McCracken, director of communications for DVHA, shared the news of the system’s restoration with lawmakers on Wednesday, saying, “we can all breathe a bit of a sigh of relief there.”
Vermont’s Medicaid pharmacy claims system wasn’t the only payment processing channel impacted by the cyberattack, however.
Change Healthcare, a subsidiary of UnitedHealth Group, operates the largest health care payment system in the United States, handling one in every three patient records in the country, and the outage has impacted a wide variety of health care providers across the nation.
In Vermont, some providers that use Change Healthcare’s billing systems may continue to experience problems as the company continues to recover from the cyberattack, McCracken said.
“There may be ongoing issues with non-pharmacy providers,” he said Wednesday. “I hesitate to come in here and say everything is resolved, A-OK, we’re all clear. From Vermont Medicaid’s perspective, we’re getting back to normal operations.”
Although the Medicaid claims system is back online, the long term outage has resulted in a backlog of unprocessed claims that pharmacists across the state will now have to contend with.
“For many pharmacies this is thousands of prescriptions that all need to basically be re-billed through Medicaid now,” Lauren Bode, executive director of the Vermont Pharmacists Association, said in an interview. “It’s going to be a lot of work to get everything caught back up, but I know pharmacies that I have talked with have already started that work.”
The long term financial impacts on pharmacies also remain uncertain. During the outage, pharmacies were unable to receive payment for prescriptions for Medicaid-covered patients, causing widespread anxieties about cash flow.
Hoping to ease some of the financial pressure on pharmacists, DVHA remitted weekly payments to them roughly equal to the average amount of money they received in Medicaid claims prior to the outage. Despite the state’s efforts, Bode said, pharmacies might still face lingering cash flow problems.
“There’s going to be a little bit of wrangling heading out of this,” she said. “I mean the system was down for a month, so it’s going to be probably another month — maybe even a little longer, maybe a couple of months — before the full effects are known.”
Bode also noted that pharmacists continue to struggle with several ongoing complications from the cyberattack, including their ability to file claims under Medicare Part B, which covers certain medical supplies like nebulizers and blood sugar test strips.
“While the Medicaid claims are getting processed, behind the scenes the system isn’t 100% back online yet, so we need an extra bit of patience and understanding that there are going to be some glitches most likely as people are interacting with their pharmacy technology systems,” Bode said.
