Texas: MESA members dig in their heels on Humana contract

Friday, August 24, 2012

CASSELBERRY, Fla. – HME providers in Texas say they’ve been losing Humana patients to Apria Healthcare “left and right,” and stakeholders worry the problem could spread.

“We fear and anticipate that we are going to see it as a national trend,” said Liz Moran, executive director of the Medical Equipment Suppliers Association (MESA), which counts Texas as one of its five member states. 

Humana and Apria entered into a multi-state preferred provider contract in 2011. Since that time, Humana has terminated existing contracts with some providers in several states.

Additionally, providers who still hold Humana contracts say their patients are being targeted. 

“Apria has been contacting our patients and telling them that they need to get their stuff through them,” said Kevin Hill, owner of CPS Medical in Tyler, Texas. “The patient doesn’t have to do that. It’s happening left and right.”

It’s one thing for Apria to encourage patients to switch, but providers say a full court press is another thing.

“They are hitting it from all angles—contacting patients, contacting us, contacting all kinds of people trying to get these people to transition over to their services,” said Cory Baker, general manager and compliance officer at Choice Medical Supply in Abilene, Texas.

MESA has begun asking its members to provide detailed accounts of problems they are having, and Moran says she plans to reach out to local lawmakers to express her concerns.

Apria, for its part, says it’s doing nothing new.

“We have a multi-state agreement with Humana,” Lisa Getson, executive vice president, government relations and corporate compliance, told HME News in an email. “In areas of the country where Apria does not have an office to serve Humana members, we have contracted with numerous small and independent providers to ensure continuity of care for the patients.”