Change Healthcare’s Cybersecurity Incident and its Potential Impact on SNF Billing and Claims Activities

Skilled Nursing Facilities (SNF); Security; Reimbursement

On Wednesday, February 21, 2024, UnitedHealth Group Inc.’s technology subsidiary Change Healthcare announced that its systems were adversely affected by a security incident. Pharmacies across the United States and other downstream users of Change Healthcare’s electronic platform continue to await a resolution to restore their ability to process claims and submit billing information electronically to health payers.

To protect client data and the integrity of their software platforms, some post-acute and long term care health information technology and electronic medical record system vendors disconnected their products from integrations to Change Healthcare’s systems last week. Unfortunately, this could have an impact on SNF billing and claims processing activities that utilize the Change Healthcare platform until resolved, particularly for the upcoming February month-end. 

While only a portion of the long term and post-acute care community may utilize Change Healthcare services to process claims submissions and billing activities, we wanted to make our members aware of this development and offer some recommended steps should you be impacted. 

Key Insights
  • Service Disruption: Change Healthcare's services are temporarily unavailable, including claims processing and accessing certain payer information. They have not specified when services will be back up and running, and current downtime is adversely impacting the submission of claims for care provided in a variety of provider settings relying on Change Healthcare resources to exchange information with varying payers.
  • No Evidence of Patient Information Breach: There is no indication that any patient data, including Protected Health Information (PHI), was accessed or compromised during this attack.
  • Future Service Restoration: Once Change Healthcare systems are back online, any claims submitted through their system before the attack and pending transactions will be processed or made available. However, Change Healthcare cannot predict exactly when processing activities will resume.
  • Support from EMR/HIT Vendors: Other entities involved in health care transactions are stepping in to help manage claim processing during this downtime. We encourage you to collaborate with your EMR and IT vendors about alternative workflows that may be available to ensure that necessary payer files reach your facilities in a timely fashion and to understand the claims submission processes that are available.​

Although it is not yet clear when all EMR/HIT providers will be able to safely re-integrate their platforms with Change Healthcare’s systems, we are continuing to gather information and will be in touch with you as soon as there are developments.

As this is an evolving situation affecting multiple sectors and organizations, we recommend long term and post-acute care providers stay alert for communications from your IT vendors, payers and other supports to access timely guidance and any available work around procedures for submitting claims that may be available.

Please contact Grant Beebe at AHCA/NCAL with any questions.