24-245 Change Healthcare Cybersecurity Incident and Its Impact to Health Net
Date: 03/06/24
On February 21, 2024, Change Healthcare, a software and data analytics subsidiary of UnitedHealth Group’s Optum unit, experienced a cybersecurity incident that has impacted its network and operations. The cybersecurity incident has created a service disruption impacting Health Net, CalViva Health and Community Health Plan of Imperial Valley, and members and provider networks in several ways. Additionally, California Health & Wellness Plan (CHWP) providers and members in counties no longer served by Health Net as of January 1, 2024, due to the new 2024 Medi-Cal contract, are also impacted for claims with dates of service prior to January 1, 2024.
As of now, Change Healthcare has not provided a timeline for resolution. To protect members and providers, we have fully disconnected system access to and from Change Healthcare on February 21, 2024. We are working on multiple solutions to restore provider functionality and ensure continuity of care for members. We will continue to provide updates as this situation evolves.
Electronic Claim Submission
(Potential impact to all lines of business)
The ability to electronically submit claims to us through Change Healthcare is currently down. Providers can easily submit electronic claims to us via many alternative methods including other claims clearinghouses and our secure provider portal. Our preferred clearinghouse for electronic claims submission is Availity. To enroll, please visit the Availity portal registration website and/or call Availity Client Services at 800-AVAILITY (800-282-4548). For step-by-step instructions for Availity, visit the Availity Lifeline page. Additional information on claims submission can be found in our provider operations manuals located in the Provider Library.
Reimbursement via Paper Check and Virtual Credit Card (VCC)
(Impacts Ambetter and Individual Medicare Advantage)
Some paper check and virtual credit card payment processes for Health Net have been disrupted due to this incident. We apologize for any inconvenience this causes. Please know we are working quickly to implement a new process to ensure payments are operational as soon as possible. An alternate way to speed up your payment process is to set up an automated clearing house (ACH) for electronic funds transfer (EFT). Health Net’s preferred ACH/EFT partner, PaySpan (now part of Zelis), has offered to help expedite the sign-up process for providers by calling 877-331-7154 or visiting PaySpan.
Chart Retrieval
(Potential impact to all lines of business)
Change Healthcare performs retrieval of medical records for several of our programs, such as HEDIS® and Risk Adjustment. You may have received a request via phone or fax from Change Healthcare on behalf of Health Net, where you either scheduled appointments or provided medical records. Change Healthcare is unable to honor any fulfillment requests at this time; however, we will be employing two of our existing medical record retrieval vendors, Datavant (formerly Ciox) and Datafied, to satisfy these prior commitments.
These retrievals are required to report on clinical quality measures and diagnosis data to Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS) and the National Committee for Quality Assurance (NCQA). We ask that you please honor the same commitment dates for these vendors, even if you have already committed to providing medical records to Change Healthcare. If you have provided medical records from the time period of February 19, 2024, to current, you may be asked to provide these medical records again.
Prior authorizations
Prior authorizations are not impacted by this incident.
Additional information
Thank you for your patience and partnership as we navigate this situation. We apologize for any inconvenience in this matter. If you have any questions, please contact your Provider Engagement representative or the applicable Provider Services Center below, or visit the Change Healthcare Outage Overview website.
Line of business | Phone number | |
| IFP Ambetter PPO | ||
IFP Ambetter HMO | ||
Health Net Employer Group HMO, POS, & PPO | ||
Medicare (Individual & Employer Group) | ||
Medi-Cal – Health Net Medi-Cal – California Health & Wellness Plan | N/A | |
Medi-Cal – Community Health Plan of Imperial Valley | N/A | |
Medi-Cal – CalViva Health | N/A | |
Behavioral Health providers | N/A |
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary Providers, Community Supports (CS) Providers, and Enhanced Care Management (ECM) Providers, and Behavioral Health Providers.
For Medi-Cal, this information applies to the following:
- Medi-Cal (all counties)
- Medi-Cal - CHW (all counties Health Net no longer serves as of 1/1/24)
- Medi-Cal - Community Health Plan of Imperial Valley
- Medi-Cal - CalViva Health