The Cybersecurity Incident at Change Healthcare
Change Healthcare, a prominent player in the U.S. insurance claim processing sector, has experienced a cybersecurity breach, leading to significant disruptions in provider and pharmacy operations. This has affected the processing of prescription claims and co-pay card services, causing difficulties for some patients in receiving their medications or having their manufacturer co-pay card support processed. The timeline for resolving these issues remains unclear.
Impact on Patients
This disruption has notably impacted the availability of medications, including Otezla and Enbrel, with some patients struggling to obtain their prescriptions and process co-pay cards, potentially interrupting their treatments. However, large national specialty pharmacies are reportedly able to continue filling prescriptions and processing co-pay cards.
Amgen’s Response to Ensure Medication Access
Amgen, committed to patient care, has initiated measures to mitigate the impact of these disruptions, particularly focusing on medications like Otezla and Enbrel.
Direct Manual Reimbursement (DMR) Program
To aid commercially insured patients, Amgen offers a Direct Manual Reimbursement (DMR) program for various medications, including Otezla and Enbrel. This program is designed to assist patients who pay for their medication out-of-pocket due to the current processing challenges. The steps for the DMR process are as follows:
• Patients must be enrolled in an Amgen co-pay card program and have an approved prior authorization on file at their pharmacy.
• They pay their out-of-pocket cost upfront at the pharmacy, which is determined by their insurance plan.
• They must retain the receipt and/or pharmacy label, which includes the product name, prescription number, prescription date filled, quantity filled, and price.
• Within 180 days from the date of payment, patients can submit these documents along with the DMR form for reimbursement.
• Patients or their legal representatives should call the Amgen SupportPlus call center to request the DMR form and receive guidance through the submission process.The specific contact numbers for Otezla and Enbrel within the Amgen SupportPlus call center are:
• Otezla: 1-844-4OTEZLA (1-844-468-3952)
• Enbrel: 1-888-4ENBREL (1-888-436-2735)eVoucher Program
Additionally, Amgen’s eVoucher program offers temporary co-pay support at participating retail pharmacies for medications like Otezla. This program can help mitigate the out-of-pocket costs for patients, depending on various factors, including their medication and insurance provider.
Conclusion
The cybersecurity breach at Change Healthcare has posed significant challenges for patients needing medications like Otezla and Enbrel. However, Amgen’s proactive approach, including the Direct Manual Reimbursement and eVoucher programs, demonstrates a strong commitment to ensuring that patients maintain access to their necessary medical treatments during this time.