MHA CEO Report — Cybersecurity Takes Center Stage

“There are only two types of companies: those that have been hacked, and those that will be.”  Robert Mueller

“Dear Health Care Leaders,

As you know, last month Change Healthcare was the target of a cyberattack that has had significant impacts on much of the nation’s health care system. The effects of this attack are far-reaching; Change Healthcare, owned by UnitedHealth Group (UHG), processes 15 billion health care transactions annually and is involved in one in every three patient records. The attack has impacted payments to hospitals, physicians, pharmacists, and other health care providers across the country. Many of these providers are concerned about their ability to offer care in the absence of timely payments, but providers persist despite the need for numerous onerous workarounds and cash flow uncertainty.”

So began a letter dated March 10 from Xavier Becerra, the Secretary of the U.S. Department of Health and Human Services (HHS), referencing what is emerging as one of the most extensive and impactful cyberattacks in U.S. history. The scrutiny directed at Change’s parent company UnitedHeath Group – from Congress, HHS, the media and others – is only just beginning, and there is no telling what sort of new regulations, penalties and associated policy change will be the end result. In the meantime, the MHA has stepped up to support our members by sharing as much information and intelligence as possible, and by advocating for flexibility and relief from both private payers and the state Medicaid program.

America’s hospitals are no strangers to external events creating seismic upheaval in our daily operations. Sometimes those events emanate from the world of public policy and politics, sometimes they come in the form of a localized natural disaster or tragic mass casualty event, and no one needs to be reminded of the impact of the global COVID-19 pandemic. But in the wake of the Change Healthcare crisis, there is no doubt cybersecurity now deserves to be on the top of the list of concerns for hospital leaders across the country, and right here in Michigan.

For some time now, the FBI has stated that healthcare organizations are the top target of cybercriminals across the globe, and these attacks have increased significantly in the last two years. Data sharing requirements in healthcare and the connectivity of health information – while well-intended – creates many potential risks for cybercriminals to exploit. Hospitals take these attacks extremely seriously. They are threat-to-life crimes because of the impact they can have on patient safety and access to care, and are formally treated as such by the FBI.

Again, this is not a new issue. A year and a half ago, cybersecurity was the topic for my CEO Report, where we expressed the potential for cybercrimes to cripple an organization. At that time, we saw how multi-national organizations with U.S.-based operations were impacted when Ukrainian government and critical infrastructure organizations were victims of cyberattacks during the Russian invasion of Ukraine. Yet again, we saw how the breach of one organization can cause rippling consequences for an entire industry; one that accounts for 17.3% of our nation’s Gross Domestic Product.

This is why the MHA has been engaged on this topic for many years and goes to great lengths to assist our members. The MHA was closely involved in the creation of the Michigan Healthcare Security Operations Center (HSOC) to help monitor and react to cyber risks with participating member organizations. We also partner with MHA Service Corporation Endorsed Business Partner CyberForceQ, a leader in the field, to assist members who need cybersecurity assistance. For the first time, we also have our very own MHA Vice President and Chief Information Security Officer, Mike Nowak, who works closely with the HSOC, our member CISOs and our external partners in this space. And Jim Lee, our senior vice president, data policy & analytics, continues to lead our MHA Health Information Technology Strategy Council, which is providing meaningful insight on the impact of this latest attack.

It can take months for a third-party review to determine what information was breached and ultimately taken. But from the hospital perspective, it is clear the Change Healthcare cyberattack is yet another example of a breach that initiates with an outside vendor, and those vendors are not always completely transparent and forthcoming with those organizations directly impacted by the breach. One thing we know for sure: our hospitals are victims in these situations and should be treated as such. We want to work with state and federal policymakers and regulatory agencies to prevent cyberattacks, and to root out and punish the criminals who perpetrate these crimes. We will be very concerned about any proposals that unfairly punish hospitals or create new barriers to our ability to provide timely access to quality care.

Our members are going to great lengths to mitigate potential risk. However, more can be done at a federal level to thwart bad actors. Hospitals and health systems are part of critical infrastructure, so our law enforcement agencies need the funding and staff to defend against cybercriminals. The American Hospital Association urged the government to use all diplomatic, financial, law enforcement, intelligence and military cyber capabilities to disrupt these criminal organizations, much like what was done in the global fight against terrorism in the wake of 9/11.

Thankfully, it appears our hospitals and health systems in Michigan have been able to manage this crisis better than counterparts in other states. The work of the MHA and our partners has helped make Michigan a leader in this space and to be prepared to respond to these situations. Our cybersecurity efforts are constantly at work, 24/7 year-round, mirroring the same cadence of our hospitals and their patient care. Yet the human component of healthcare is the most vulnerable. It only takes one individual to not notice a phishing or social engineering attempt for yet another failure that can impact hundreds of organizations, thousands of healthcare workers and tens of thousands of patients. This is why we must remain constantly vigilant as the cyber threat landscape continues to grow.

As always, I welcome your thoughts.

MHA Monday Report March 11, 2024

MHA Monday Report

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News to Know

MHA-member communications professionals are encouraged to save the date for this year’s MHA Communications Retreat, scheduled from 8:30 a.m. to 4 p.m. Tuesday, May 7, at the Henry Center for Executive Development in Lansing.


MHA CEO Brian PetersMHA in the News

Chief Healthcare Executive published an article March 5 about the impact of the Change Healthcare cyberattack on hospitals and health systems across the country. The publication spoke with several state hospital associations representing Michigan, Florida, …

Change Healthcare Outage Continues to Impact Members

The MHA has been in close contact with the American Hospital Association (AHA), the Michigan Healthcare Security Operations Center (HSOC) and other partners regarding the Change Healthcare cyberattack that has impacted hospitals nationwide over the past two weeks.

The MHA is gathering, in aggregate, data about the impact of the attack on Michigan hospitals and patients. If your hospital/system hasn’t already done so, please complete this short questionnaire as soon as possible to help the MHA continue to advocate, and tell an accurate story of impact, on members’ behalf. Members with questions about the survey may contact Jim Lee at the MHA.

The latest updates from last week include:

  • Federal Advocacy: The AHA, the MHA and other state hospital associations have been urging Congress and the US Department of Health and Human Services (HHS) to prioritize and expedite hospital requests for Medicare advanced payments; issue guidance to payers about interim payments, waiving of prior authorizations, not denying claims due to lack of prior authorization and more. A letter was sent to HHS Feb. 26, and was followed up with a letter March 5 to House and Senate leadership requesting whole-government response, and that Congress consider any statutory limitations that may exist for agencies assisting hospitals at this critical time. Members with questions about federal efforts should contact Laura Appel at the MHA.
  • Pharmacy: Optum announced that e-prescribing is now fully functional, as are pharmacy claim submission and payment transmission.
  • Payments: Electronic payment functionality should be available for connection again March 15.
  • Medical Claims: Optum will be testing to reestablish connectivity to their claims network and software March 18, restoring service throughout that week.

Optum announced March 1 a Temporary Funding Assistance Program to help bridge the gap in short-term cash flow needs for providers who received payments from payers that were processed by Change Healthcare. UnitedHealthcare stated they will provide further funding solutions for providers. According to their most recent press release, “This applies to medical, dental and vision providers and will involve advancing funds each week representing the difference between their historical payment levels and the payment levels post attack. Advances will not need to be repaid until claims flows have fully resumed. Providers must complete a one-time registration to access funding. For those who receive funding support, there are no fees, interest or other associated costs with the assistance. For repayment, providers will receive an invoice once standard payment operations resume and will have 30 days to return the funds. These terms now apply to both the original and expanded funding programs.”

Providers must register for the program at the website: www.optum.com/temporaryfunding.

More details on these updates are available on the United Health Group’s website dedicated to updates on this issue. This site also has FAQs, contact points for assistance and more.

Resource reminders:

  • AHA tools/updates on Change Healthcare incident.
  • CyberForceQ, an MHA-vetted expert and leader in the field for members who need cybersecurity assistance.
  • Members with questions about cybersecurity and the HSOC may contact MHA Vice President and Chief Information Security Officer Mike Nowak at the MHA.

 

Chief Healthcare Executive Quotes Peters on Cybersecurity

MHA CEO Brian Peters

Chief Healthcare Executive published an article March 5 about the impact of the Change Healthcare cyberattack on hospitals and health systems across the country. The publication spoke with several state hospital associations representing Michigan, Florida, Massachusetts, Pennsylvania and Washington. MHA CEO Brian Peters is quoted in the story discussing why healthcare is a frequent target of cybercrimes and what the effects of the attack have been in Michigan.

“We are aware the cybersecurity event has impacted healthcare services, including patients’ ability to receive prescriptions and hospital billing,” said Peters. “However, the impact varies by organization, depending on each hospital’s or health systems’ existing relationships with Change Healthcare.”

Members with any questions regarding media requests should contact John Karasinski at the MHA.

Peters Appears in CNN & Crain’s Stories

MHA CEO Brian Peters

MHA CEO Brian PetersThe MHA received media coverage the week of Feb. 26 that includes quotes from MHA CEO Brian Peters appearing in stories by CNN and Crain’s.

CNN published an article Feb. 26 on the Michigan economy and aging population. Included in the story is a section on healthcare emerging as the state’s largest private sector employer. The section highlights how the aging population is leading to an increased need for healthcare services and references the 27,000 job openings in Michigan hospitals.

“Those folks who are headed off to their retirement days, they are the ones who demand more health care services,” said Peters.

Crain’s Detroit Business reported on the Change Healthcare cyberattack in a story published Feb. 29. The story looks at how market consolidation and the growing need for data sharing has led to higher cybersecurity risks for healthcare organizations. Peters mentions how healthcare is the top target for cybercriminals and explains the challenges faced by hospitals.

“These continued cybersecurity challenges stem from the complex and interconnected nature of hospital information technology systems, which often require integration with external software and hardware to support clinical operations, patient care and administrative functions,” said Peters. “Furthermore, hospitals must navigate a regulatory landscape that demands compliance with health information sharing, privacy and security laws, making the management of third-party risks a critical, yet challenging, aspect of their cybersecurity strategy.”

Crain’s Grand Rapids also published an article Feb. 26 on new state laws that increase the penalties for violence committed against healthcare workers or volunteers. The story looks at the increased rates of violence committed against healthcare workers and the issues it creates for workplace safety, recruitment and retention.

“It is flat out inappropriate to physically attack a healthcare employee and there are going to be consequences if and when it happens,” said Peters. “It’s a signal that we’re not going to tolerate this anymore.”

Members with any questions regarding media requests should contact John Karasinski at the MHA.