Massachusetts Medicaid transitions to preferred supplier

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Friday, February 9, 2018

BOSTON – If HME providers have to deal with a preferred supplier for incontinence supplies, a new Medicaid contract in Massachusetts might be the way to go.

Because the upcoming contract between MassHealth and Geriatric Medical is a preferred supplier not a single-source contract, providers can still buy incontinence products from other distributors and manufacturers, points out Karyn Estrella, president and CEO of the Home Medical Equipment and Services Association of New England (HOMES).

“When it comes to bidding of any kind, this is the best-case scenario we could ask for,” she said.

The contract between MassHealth and Geriatric Medical, a Woburn, Mass.-based supplier of wholesale medical products, goes live March 1.

Other advantages of the contract include MassHealth’s selection of a local company and its insistence on keeping the provider network intact. Other states have allowed distributors to go direct to consumer, cutting out providers.

“We’re committed to working alongside the provider network to deliver better care at a lower cost to MassHealth members,” said Jeffrey Siegal, CEO of Geriatric Medical Supply.

While the general idea of the contract appears better than other alternatives, Estrella and other stakeholders still have a number of questions, including the implications, if any, of providers choosing to buy incontinence products from other distributors and manufacturers.

“What if they’re audited?” Estrella asked. “How do they prove that these other distributors have met the same quality standards that the preferred supplier, Geriatric Medical, has? There are still some unknowns.”

Also embedded in the contract are reimbursement cuts, but they’re not as bad as they could have been, Estrella says.

“The state worked with several of our members who shared the cost of providing incontinence products, and the state did not realize everything that is involved,” she said. “My understanding is that this had a positive impact on the reimbursement—that they came up from what they were originally thinking.”