Yesterday, Optum Rx circulated a letter to its pharmacy partners addressing last week’s cyber attack on Change Healthcare, leaving pharmacies in the lurch on claims. NCPA has been vocal about the delayed response, going on nearly a week now, and Optum’s letter comes just two days after NCPA CEO Douglas Hoey and senior vice president for pharmacy affairs Ronna Hauser met with its executives to ensure “pharmacies aren’t left holding the bag,” as reported in qAM.
Optum’s letter notes that it took immediate action to disconnect Change Healthcare’s systems, containing damage, and the company’s CEO, Patrick Conway, expressed “a high level of confidence” that OptumRx, United Healthcare, and UnitedHealth Group’s systems were unaffected.
The guidance it offered pharmacies is short on details of how claims waiting to be processed by pharmacies and affected Medicaid programs will be handled, but they offered this:
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If a pharmacy has multiple switch vendors: Divert traffic away from Change.
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If Change is the only switch vendor: Use “offline” processes where a prescription is dispensed and then submit once systems are back up.
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Use good faith approaches to confirm eligibility, such as looking at whether it is a refill for a prescription previously adjudicated, or by checking the pharmacy portal or calling into the Optum Rx Pharmacy Help Desk at (800) 880-1188 so we can assist.
