A recent cyberattack exposed the personal information of more than 2 million current and former Harvard Pilgrim Health Care customers, including in New Hampshire. But it has also interfered with the insurer's ability to pay out medical claims, and some local providers say that's creating significant strain.
Point32Health, Harvard Pilgrim’s parent company, confirmed to NHPR that they have been unable to accept and process claims due to system outages following the incident, but providers should be able to once again submit claims as of last week.
Darcy Killerby, who owns Align Counseling Associates in Manchester, said the insurer owes her therapy practice $11,000. She said the missing payments have made running her practice increasingly difficult and affected her ability to pay her staff.
“The other therapists that work for me are contractors, so they don’t get paid until insurance pays out, other than copays or clients who pay out of pocket,” she said. “So they are feeling the impacts in their checks.”
According to a 2021 report from the New Hampshire Insurance Department, Harvard Pilgrim covers 40% of the state’s large and small group markets. The insurer currently covers about 72,000 people in New Hampshire.
At Family Health Center in Lebanon, business manager Kathy Bean said Harvard Pilgrim has not paid any claims since at least April 15, two days before the insurer says it discovered the ransomware attack.
“It is affecting a small business like us,” Bean said. “Every penny makes a huge difference.”
According to Point32Health, providers can submit claims for Harvard Pilgrim commercial and Medicare supplement members again as of June 15, although some of the system’s functionality remains limited and claims could take 6 to 10 weeks to process.
In response to questions from NHPR, Point32Health spokesperson Kim Winn said the company can apply interest to claims that were not processed due to the system’s outage. She also said they provided bridge payments to providers that requested.
However, local providers who spoke to NHPR said they were unaware of this information and had received limited communication from the insurer.
Laura Darling, a speech pathologist and the founder of Kidspeak Language Learning Services in Concord, said she has not been paid by Harvard Pilgrim since April 18. She said the emails she has received from the insurer have been unhelpful and her attempts to reach out for more information unfruitful.
Darling said that her patients who are covered by Harvard Pilgrim and related insurers told her they were unaware of the payment issues until she alerted them.
Winn, with Point32Health, said the company “communicated with members using the channels that were available to [the company] at the time.”
“We expect to communicate directly with our members in the coming week about the incident and our current state of operations, as we have recovered and are updating direct contact information,” she added.
Darling said she has continued providing care for affected patients but is worried that other providers might turn away potential patients with Harvard Pilgrim due to the payment issues.
Point32Health’s website says that patient care will not be interrupted and that providers must continue seeing patients, but it is unclear what tools the company has to enforce this measure.
The New Hampshire Insurance Department said it became aware of the security incident “within hours of its occurrence” and it has been in communication with Harvard Pilgrim and Point32Health “to understand the scope and severity as it pertains to consumers and providers alike.”
The state insurance agency did not provide on-the-record responses to specific questions about the payment delays as of press time. But they pointed to steps that Harvard Pilgrim has taken to protect consumers, such as waiving prior authorization and offering identity theft protection services.
“We are in constant contact with HPHC to monitor the situation and will continue to work with HPHC to ensure that Granite State consumers are protected, and providers can continue to deliver care,” New Hampshire Insurance Department Communications Director Andrew Demers said.
