Subscribe to RSS - managed care

managed care

NSM now in-network with Prime Health Services


NASHVILLE, Tenn. – National Seating & Mobility has been designated as a preferred complex rehab and home accessibility provider for Prime Health Services, a managed care company specializing in preferred provider networks.

North Carolina rate protects DME


RALEIGH, N.C. – North Carolina Gov. Roy Cooper on July 2 signed Bill 808, including a provision creating a rate floor for durable medical equipment.

Payers tighten their control

Of a recent Centene-WellCare merger, one provider cited Centene’s ‘track record’ in Illinois

ST. LOUIS – As big payers get ever bigger, HME providers and stakeholders fear the impact these monopolies could have on the market.

Centene, WellCare merger finalized


ST. LOUIS – Centene Corp. has completed its acquisition of WellCare Health Plans, creating what it calls the leading healthcare enterprise focused on government-sponsored healthcare programs.

Monroe Wheelchair works system


SYRACUSE, N.Y. – With the rise of managed care organizations in Medicaid, especially in New York, it’s been worth it for Monroe Wheelchair to have a contract relations manager on staff, Doug Westerdahl says.

Auditors avoid appeals process, make ‘major’ requests


YARMOUTH, Maine – If you’re an HME provider trying to appeal a denial by a managed care payer, it’s probably not going very smoothly, reports consultant Wayne van Halem.

Payer Relations Council sets agenda


WASHINGTON – AAHomecare’s new Payer Relations Council met for the first time in Arlington, Va., last week, to establish objectives for 2020, including educating the payer community on the value o

MCO bill becomes law in Kentucky


FRANKFORT, Ky. – Kentucky Gov. Matt Bevin has signed into law a bill that streamlines DME regulations and reimbursement policy for the managed care organizations managing the state’s Medicaid program.

The bill ensures that MCOs:

Medtrade Spring preview: Don’t get ‘railroaded’ by MCOs, says speaker Pam Colbert


LAS VEGAS – Now that Medicare and Medicaid are turning to managed care organizations (MCOs) more and more to cut costs, HME providers must be vigilant to make sure they get a fair deal, says Pam Colbert, an attorney with Brown & Fortunato.

NCART seeks managed care data


BUFFALO, N.Y. – NCART has developed a survey for suppliers and manufacturers to share information on reduced access to complex rehab technology at the hands of Medicaid managed care organizations.