Pharmacy vendor network interruption affects Utah Medicaid operations

Utah pharmacies and Medicaid members impacted by national cyber security issue 

February 22,2024 – On Wednesday, February 21, Change Healthcare, which operates as the Utah Medicaid pharmacy vendor for members whose prescriptions are paid directly by Medicaid (known as fee for service), reported they were experiencing a cyber security issue on their systems. Optum took immediate action and disconnected their systems to reduce further impact.  

With the network and system outages, Medicaid staff have been unable to access any pharmacy claim information, including placing overrides and prior authorization information for these members. This outage is impacting Medicaid members who are attempting to fill a prescription and are not enrolled in a managed care plan or seeking to fill a behavioral health medication.  

The Utah Department of Health and Human Services (DHHS) does not want any member to have delayed care as a result of this system issue. DHHS is doing everything possible to communicate with providers, pharmacies, stakeholders, and members to implement work-around options so that emergency prescriptions can be filled.  

DHHS is advising pharmacies to provide a 72-hour emergency supply of medication at no cost to the member. DHHS will continue to communicate to pharmacies with specific instructions and reimbursement processes.

This issue is not limited to Utah Medicaid members and providers. Optum provides technology and data to insurance companies and healthcare services nationally. They claim to handle one in three U.S. patient records. Local pharmacies are experiencing system outages, which affect people not enrolled in Medicaid, as well.

Change Healthcare anticipates that these disruptions will last through the day, if not longer.  They are providing updates on their website.