Who’s to blame for Univita's collapse?
I am reading the Univita story in the latest edition and something is missing or was lost in translation (“Chaos erupts as Univita loses biz,” p. 1, September 2015).
Univita did not contract with AHCA (Agency for Healthcare Administration) who oversees the Statewide Medicaid Managed Care (SMMC)—Managed Medical Assistance Program (MMA). Univita contracted with the various standard managed health care plans. I do not know if all the plans were using Univita, but many where.
It is easy for us to point the finger at AHCA, however, it was the health plans who were trying to save money on DME. Many of the plans are large providers who have DME contracts for Medicare Advantage and similar plans. They know what DME costs. It is the health care plans who signed the DME contracts with Univita, not AHCA.
It would seem reasonable that AHCA has some sort of contractual performance requirements for the health care plans. Given that assumption, shouldn’t industry be watching to see what AHCA’s direction is regarding the affected health care plans noncompliance or nonperformance of contract?
Univita is history; we should be looking forward to see if the managed care plans will have adequate reimbursement levels to provide the DME services mandated by AHCA. Florida Medicaid has many provision of service requirements exceeding Medicare. The health care plans need to take this into consideration, too.
—Bob Lichtenstein, Hollywood Medical Supply, Hollywood, Fla.