Economic Liberties Urges HHS & ONC to Bolster Electronic Claims Standard Following Change Crisis

March 12, 2024 Press Release

Washington, D.C.—As a cyberattack on UnitedHealth Group-owned healthcare payments exchange Change Healthcare continues to paralyze broad swaths of the US healthcare system, the American Economic Liberties Project today sent a letter to the Department of Health and Human Services and Office of the National Coordinator for Health Information Technology, calling on them to implement a new electronic claims standard to boost the resilience of America’s healthcare payments infrastructure. The letter comes alongside a new Economic Liberties fact sheet breaking down the Change Healthcare cyberattack and the role of corporate consolidation in driving it.

“Nearly three weeks after this disaster, countless patients are still struggling to access critical medication and care—and community medical practices are facing life-or-death liquidity crises—all because one intermediary has been allowed to grow into a single point of failure for the entire healthcare system,” said Erik Peinert, Research Manager and Editor at the American Economic Liberties Project. “While one takeaway here is that judges must stop approving mergers that create chokepoints in such critical markets, federal regulators must also use available tools to foster resilience, such as introducing new Electronic Data Interchange standards that allow providers to use multiple clearinghouses. Regulators must update these rules to reinforce the payments system with competition and redundancies, and to prevent a monopoly’s complacency from sparking another catastrophe.”

Change Healthcare is a healthcare electronic data exchange that processes at least half of all health insurance claims and is the largest private processor of prescriptions in the US. Just two years ago, it was acquired by Optum Health—owned by notorious monopolist UnitedHealth Group—igniting concerns that UnitedHealth may have invested in acquiring and integrating Change rather than in data security. In another twist, UnitedHealth is now reportedly capitalizing on the crisis its consolidation and security failure have created, buying up desperate community medical practices unable to access cash amid the outage.

Current government regulation exacerbates this fragility by implementing data interchange standards that make it difficult to have two clearinghouses for a single provider, and also make it difficult to switch clearinghouses. As the letter to HHS and ONC argues, the expectation should be that claims transmission can occur through multiple, redundant vendors—in the same way that hospitals have maintain redundant power supplies, generators, and internet connections.

Read the letter here.

Read the fact sheet here.

Learn more about Economic Liberties here.

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The American Economic Liberties Project works to ensure America’s system of commerce is structured to advance, rather than undermine, economic liberty, fair commerce, and a secure, inclusive democracy. Economic Liberties believes true economic liberty means entrepreneurs and businesses large and small succeed on the merits of their ideas and hard work; commerce empowers consumers, workers, farmers, and engineers instead of subjecting them to discrimination and abuse from financiers and monopolists; foreign trade arrangements support domestic security and democracy; and wealth is broadly distributed to support equitable political power.