Molina Healthcare taps DME Navigator platform to manage DME benefits in three more states

YARMOUTH, Maine – Molina Healthcare of Iowa will implement a new DME Navigator program for members in all lines of business starting in the fall. The payer also has plans to use the platform in Nebraska and Wisconsin.

What durable medical equipment providers in Iowa need to know:

• Molina is subcontracting the DME network to Optum for the in-scope DME products and services.
• CareCentrix will contract, credential and manage a network of DME providers rendering in-scope products and services to Molina members.
• DME providers will need to be contracted directly with CareCentrix. If a provider chooses not to join the CareCentrix network, members receiving in-scope DME products and services will be transitioned to the CareCentrix network. Your existing contract with Molina does not carry over to CareCentrix.
  • To join the CareCentrix network, please contact DMEContracting@carecentrix.com to get started.
• Orders for in-scope DME products and services for Molina members will be submitted through the DME Navigator POC Platform. Services should not be rendered until DME Navigator POC has approved you as the servicing DME provider. Services not provided according to the DME Navigator POC process are ineligible for reimbursement.
• After being selected to be the rendering provider by DME Navigator POC, authorizations for in-scope DME products and services will still be submitted through the standard submission process to Molina.
  • At a future date, to be announced, Molina will be transitioning authorization of in-scope DME products and services to the DME Navigator program.
• After rendering the approved services, claims for DME products and services will be submitted through the standard submission process and adjudicated by Molina. Reimbursement eligibility is dependent on your agreement with CareCentrix and is subject to applicable state, federal and coding guidelines.
• Continuity and Transition of Care will be managed by CareCentrix for in-scope services.

Molina also notes that providers that order / prescribe DME will need to enroll with Parachute Health to access the DME Navigator platform.

The Midwest Association of Medical Equipment Services (MAMES) is surveying providers to gauge the impact of the new contract and to inform its advocacy efforts.

The association is also surveying providers in Nebraska and Wisconsin, where Molina also plans to transition to DME Navigator on Sept. 1 and Aug. 1, respectively.

• Related: Molina Healthcare selected CareCentrix to manage all lines of business effective June 1, 2026, in Illinois, Washington state, South Carolina and Ohio. It plans to expand to all 18 states it serves.