Medi-Cal, providers discuss pricing, specs for disposables

Wednesday, January 31, 2007

SACRAMENTO, Calif. - Contracting for underpads took center stage at a November meeting between players in the disposables market and California Medicaid.
Medi-Cal already contracts with manufacturers for briefs and other incontinence products, and plans to add underpads to its roster. However, providers are concerned about proposed product specifications, which many feel are beyond the capability of an underpad, said Bob Achermann, executive director of the California Association of Medical Product Suppliers (CAMPS).
"They were trying to make it act like a brief and it's not," said Achermann. "It is designed to protect furniture and bedding, and be worn in conjunction with a brief."
Product specifications include absorbency, use in the home and beneficiaries' needs.
"There is nothing wrong with minimum standards," said Achermann. "But there was also concern the intent was to make this a non-benefit because no one could make underpads available at what Medi-Cal wanted to pay."
After meeting with Medi-Cal, CAMPS formed a workgroup to develop a single recommendation to the department based on product characteristics, reasonable expectations of the products and the proper way to test them.
Laura McIlvaine, CAMPS president and director of government affairs and reimbursement oversight for Shield Healthcare, said she was optimistic about the outcome.
"It was a good, productive meeting," said McIlvaine. "Going forward, the rates should be workable for all parties involved."