"The government really didn't rise to the challenge the way that it should have,” notes Ben Jones, vice president of government relations and public policy for The US Oncology Network. “Practices were in distress…stretching all resources to figure out workarounds."
The Change Healthcare cyberattack continues to reverberate, and will for some time. In this interview from our coverage of the 2024 Community Oncology Conference, Ben Jones, vice president of government relations and public policy for The US Oncology Network, a panelist for “The Politics of Oncology: Legislative Updates & Predictions From Capitol Hill,” gets candid about the government’s response to these still very recent events.
“The government really didn't rise to the challenge the way that it should have,” Jones emphasizes. “Practices were in distress…stretching all resources to figure out workarounds… And it was almost like the government just looked at it through the lens of Covid and didn't get it right.”
Transcript
What is your assessment of the government’s handling of the Change Healthcare cyberattack?
This morning's panel conversation was very interesting and timely, and I think really got thrown off script because of Change [Healthcare]. I think everybody was coming in planning to talk about a dozen issues that are impacting community oncology practices, but all of that has really been put to the side while we deal with this disaster of [the Change Healthcare attack].
And candidly, I think what we're dealing with regarding the cyberattack, as it relates to the government's role, really shows one thing, which is the government really didn't rise to the challenge the way that it should have. Practices were in distress, practices were in a very unique situation very different than COVID-19. During COVID-19, practices were on the brink, largely because volumes fell. And during COVID-19, there was nobody coming in. And when they did come in, there were new PPE [personal protective equipment] expenses, spacing requirements—all of these costs that had to be infused into the practice at a time when volumes were lower.
The disruption as a result of the Change cyberattack was a little different, because volumes weren't changed. And you could arguably say that they were increasing a little bit because coming out of the new year. You saw volumes increasing or remaining steady, but there was no cash flow coming in. These patients were there, every practice was stretching all resources to figure out workarounds, “How can I do this manually? What do I need to do over here? We don't want to disrupt patient care.” So they're working overtime, they're doing manually what used to be done with a click of a button. At overtime salaries, everyone is on the brink. But cash flow is not coming in to pay for these additional resources.
And it was almost like the government just looked at it through the lens of COVID-19 and didn't get it right. They put together a couple of proposals, they finally extended the accelerated payments to community practices, but it was very ambiguous the way that the program was rolled out. And then they started to push forward a couple of recommendations like, “We encourage the Medicare Advantage plans to exercise relief and flexibility and prior authorizations.” Well, recommending somebody does something in a time of crisis isn't the right approach. We need support, we need the federal government to come in and say, "This needs to be fixed."
It's a disruption that we're going to have to work through over the next few months. This is not going to be a light switch. Even if we get processes back in place, we're going to have to figure out how to reconcile all of the claims that had taken place over the last month and a half. And that's where we're going to need Medicare to really be forceful to say, “No! We need to make sure that practices who did the right thing on behalf of the patients, they are made whole.” And whether that is teeth around exercising prior authorization or ensuring that the process can run smooth, to backtrack all these claims, we need that federal government support.
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