Medicare Advantage plan backs off

Thursday, October 22, 2015

STILLWATER, Minn. – A Medicare Advantage plan in Minnesota that sought to do business only with contract suppliers from Medicare’s competitive bidding program has backed off.

Two providers in the state had notified the Midwest Association of Medical Equipment Services that they had received a letter from the plan outlining the change.

“They didn’t hear back, so basically, they dropped the issue,” said Rose Schafhauser, executive director of MAMES. “And we haven’t had it pop up again.”

Stakeholders fought the change, arguing that the plan couldn’t apply the results from another program, especially when it meant providers already doing business with the plan would no longer be able to.  

The plan had also indicated that it sought to implement competitive bidding pricing. 

“If they’re not using the pricing, they’re very close to it,” Schafhauser said of Medicare Advantage plans, in general.

Medicare Advantage is an area that stakeholders like Schafhauser are keeping a close eye on. Enrollment in these plans is higher than it has ever been and the number of states looking to managed care to run their Medicaid programs is increasing.

“Managed care is on fire right now,” she said.