As of 2/27/2024 3:14 PM CST, MedOne has successfully established connectivity with an alternative routing vendor and claims are processing.
MedOne is now processing claims through RelayHealth, and all pharmacies using RelayHealth will now be able to successfully submit claims to MedOne. For members who may have paid out of pocket over the past few days, we encourage them to work with their pharmacies to reverse and reprocess their prescriptions through insurance to avoid having to submit a Direct Member Reimbursement form to be reimbursed.
While we believe many pharmacies have pivoted to RelayHealth during the outage, there may still be pharmacies unable to process claims. For those instances, we reinforce our previous communication and resolution strategy noted in prior communications.
For any members needing assistance, please encourage them to contact our Member Advocate team at 866-335-9057.
What Happened:
On Wednesday, 2/21/2024, Change Healthcare, part of UnitedHealth Group, suffered a cyber security attack from a suspected nation-state per its SEC filing. Among other services, Change Healthcare supports the routing of prescriptions from pharmacies to PBMs. In response to said attack, Change Healthcare disconnected its prescription routing service to limit impact. As of 2/28/2024 at 8:07AM EST, the outage persists. Change Healthcare expects the disruption to “last at least through the day.”
Updates directly from Change Healthcare may be found here:
https://status.changehealthcare.com/incidents/hqpjz25fn3n7
For clarification, MedOne systems and data were NOT the target of the cyber security attack. Our systems were not affected or impacted. At this time, there is no indication that MedOne systems or data have been compromised. Claims that can be successfully routed from a pharmacy to MedOne will correctly process.
MedOne is committed to ensuring access to care for our members and apologize for any inconvenience our members may experience. For escalated member issues, MedOne has an Emergency Response Team to assist members in securing their emergency medications during this outage.
We are actively monitoring the outage to keep abreast of adjudication status and downstream impact. Please contact your account manager or the MedOne Member Advocate Team at 866-335-9057 with any additional questions at this time.