On April 17, Point32Health, the parent company to Harvard Pilgrim Health Care (HPHC) and Tufts Healthcare identified a cybersecurity ransomware incident that impacted systems used to service members, accounts, brokers and providers. At this time, most systems impacted are on the HPHC side of business. After detecting the unauthorized party, and out of an abundance of caution, Point32Health proactively took certain systems offline to contain the threat.  Law enforcement and regulators were notified, and third-party cybersecurity experts are involved to conduct a thorough investigation into this incident and remediate the situation.

As Point32Health responds to this incident, the top priority is, and remains, providing access to care for members.  While working diligently to restore affected systems as quickly and as safely as possible, the team is working around the clock to ensure Harvard Pilgrim Health Care members receive the services they need. This includes:

• A special phone line: HPHC members who have urgent needs can call (800) 260-0574 if they need assistance with matters related to access to care, while systems are down. If members call the Member Services number on the back of their ID card, they will hear an automated message that directs them to the urgent assistance phone number listed above.
• A dedicated web page: The Point32Health website will serve as the online hub for important information and updates related to the system outage. This page will be updated as more information becomes available.
• NEW: Utilization Management (UM) for Medical and Behavioral Health Services
  Effective April 19, 2023, and until further notice, Harvard Pilgrim Health Care Commercial and New Hampshire Medicare Stride℠ plans are temporarily waiving utilization management (UM) requirements, including prior authorization and notification, for medical and behavioral health covered services, except for the following, which will continue to require prior authorizations:
  – CAR-T Cell Therapy
  – Gender-affirming surgical procedures
  – Solid organ transplant surgeries
  Authorizations will be backdated, as appropriate, once the systems up and running again.
• NEW: UM for Pharmacy Benefit and Medical Benefit Drugs:
  The current UM requirements, such as referrals and authorizations, remain in place for pharmacy benefit and medical benefit drugs, as those systems continue to function normally.
• For specialty pharmacy help, call 844-265-1705.
  For OptumRx home delivery help, call 855-258-1561.
  For help with your OptumRx online account, call 844-813-7271

Please refer back to NEEBCo’s In the News tab for updated information as it becomes available.