Real gangster tactics

I’m going to start with the OT warning this time: Please stay on topic in the comments for this post. An interesting post that also has open comments is here.

Change Healthcare, a subsidiary of UnitedHealth Care, was handling about one-third of all medical claims before it was hit by a catastrophic ransomware attack early last year.

Change had to shut down. That meant that payment for approximately a third of all medical claims stopped. The results of an AMA survey gives some hint of how not good this was, especially for smaller groups like this internal medicine practice in Pennsylvania.

The six-physician primary care practice, which also includes 20 other health professionals, “immediately saw revenue dry up, from tens of thousands of dollars of deposits every day to tens of hundreds in revenue,” Meyer said in a phone interview. With a payroll of $250,000 to make every 2 weeks, “we were scrambling,” she said.

Then, OptumFinancial, also a subsidiary of UHC, offered the practice a loan. For the clusterfuck that UHC subsidiary Change had caused.

“Right about that time, Optum Financial [also part of UnitedHealth Group] offered temporary financial assistance loans, and told us they’d automatically deposit funds into our direct deposit accounts for some percentage of what they’d expect us to bill through their clearinghouse,” Meyer said. Her practice ended up taking about $750,000 in loans from Optum.

Because their billing system didn’t end up coming back online fully until September 2024, “that $750,000 was critical for us,” she explained. In total, the practice lost about $1.2 million as a result of the cyberattack, Meyer said. “There is a big misconception this billing caused a delay in revenue … That’s not at all what happened.” Instead, the practice ended up submitting claims every other way it could — via fax, on the phone, on other portals — but had no way of knowing which claims were accepted, which were denied, and which were turned down due to clerical errors like a wrong digit. Therefore, a lot of the potential claims revenue just never materialized.

Last year, during a Senate Finance Committee hearing, UHC’s CEO (not that one) said that providers wouldn’t need to repay the loans until 45 days after their business returned to normal. Anyone who knows anything about organized crime, or who has seen the Army Protection Racket sketch can guess where this tale is going.

In January, Meyer received a letter from Optum asking whether the practice could start repaying the loan. Meyer called and explained that she wasn’t yet able to, and Optum told her the loan was now being handled by a different corporate division, which would give her a call. But Meyer never received that call, “so I figured they figured it out and were going to leave us alone for a while,” she said.

But instead, she got a letter on April 1 — sent to her address but to a different entity — saying that she owned $950,000 and would need to start paying it back right away.

Nothing says “We’ve certainly learned our lesson about the importance of carefully handling data” like mailing the wrong information to the wrong person. But what’s one more wee whoopsie from a company worth more than $530 billion when it is in pursuit of $750,000?

When Meyer called to explain that they had sent it to the wrong practice and that she only owed $750,000, the company acknowledged its error but said she still owed the $750,000 and asked her to arrange a payment plan. When Meyer said she still couldn’t do that, the company said it would begin withholding payments for care she gave to UnitedHealth Group patients. “I said, ‘You’re going to withhold payments for patient care we have already delivered until you recoup this money?’ And [the company representative] said, ‘Yeah, we’re prepared to do that.'”

‘Ow many medical assistants you got, doctor? Be a shame if someone to set fire to ’em.