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Tag: Managed Care Organizations (MCOs)


Tomorrow Health courts Medicaid MCOs 

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Tomorrow Health courts Medicaid MCOs 

April 4, 2023HME News Staff

NEW YORK – Tomorrow Health has announced new technology that it says can help Medicaid managed care organizations move beyond analog fax and phone workflows for home-based care, get up-to-the minute insight into order status and better manage members with complex cases. The company says its technology can provide an extra layer of efficiency by providing care coordinators with important DME-related information, such as referring provider details, product category estimated delivery date, confirmed...

Managed Care Organizations (MCOs), Medicaid, Tomorrow Health


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Home Care Alliance seeks to expand network 

March 21, 2022HME News Staff

HALIFAX, Va. – The Home Care Alliance of Virginia seeks to expand its DME provider network to serve patients of the United Mine Workers of America Health and Retirement Funds. HCAV is one of seven contractors serving UMWA beneficiaries nationwide and is currently seeking providers in multiple areas, including Utah, Wyoming, Illinois, Pennsylvania, West Virginia, Kentucky, Tennessee, Alabama and Missouri. HCAV provider members can serve UMWA patients in their service areas under the HVAC contract....

Durable Medical Equipment (DME), Home Care Alliance of Virginia, Managed Care Organizations (MCOs)


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Florida: MCO legislation fails to cross finish line

March 17, 2022HME News Staff

TALLAHASEE, Fla. – Language that would have required managed care organizations in Florida to reimburse at no less than 100% of the state’s current Medicaid DME schedule was not included in the final version of an appropriations package, according to AAHomecare. “While we didn’t accomplish our top goal this time around, I am convinced that the extensive work engaging legislators, the Agency for Health Care Administration, the Governor’s office, the Florida Association...

Florida, Home Medical Equipment (HME), Managed Care Organizations (MCOs)


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Florida providers push hard to safeguard Medicaid

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Florida providers push hard to safeguard Medicaid

February 4, 2022Theresa Flaherty, Managing Editor

TALLAHASSEE, Fla. – Providers in Florida believe new legislation aimed at improving the state’s Medicaid managed care program will provide much-needed stability in a state that has had a troubled relationship with the program in the past.  Introduced in January, House Bill 1165 and Senate Bill 1540 would require payers to reimburse providers at 100% of the state’s fee schedule for durable medical equipment and complex rehab technology.   “The cost of goods,...

FAHCS, Florida, Home Medical Equipment (HME), Managed Care Organizations (MCOs), Medicaid Managed Care


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In brief: Rotech files IPO, Numotion buys SpinLife, NC goes with rate floor

July 9, 2021HME News Staff

ORLANDO, Fla. – Rotech Healthcare Holdings has filed for an initial public offering of up to $100 million and plans to list on the Nasdaq under the symbol ROTK.  The company had $534 million in sales for the 12 months ended March 31, 2021.  Rotech Healthcare offers a comprehensive range of home medical equipment and products and services across five core business lines: oxygen, ventilators, sleep therapy, wound care and DME. The company's payer mix includes commercial insurers,...

Initial Public Offering (IPO), Managed Care Organizations (MCOs), Numotion, Rotech Healthcare, spinlife


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State news: Oklahoma, Louisiana, New York

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State news: Oklahoma, Louisiana, New York

June 14, 2021HME News Staff

The Oklahoma Health Care Authority does not have the authority to implement a managed care plan for the state’s Medicaid system, according to a State Supreme Court ruling. The ruling was cheered by the Oklahoma Medical Equipment Providers Association and other health care providers who have been fighting the proposed move in the state legislature and in the courts. “OMEPA and other health care leaders in Oklahoma have done an exceptional job in spotlighting the potential impacts of the...

Managed Care Organizations (MCOs)


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MCOs and Medicaid: Call for support in NY 

March 2, 2021HME News Staff

ALBANY, N.Y. – AAHomecare is calling on providers in New York to help build support for two new bills in the state legislature that would require Medicaid managed care organizations to reimburse for DME and complex rehab at no less than 100% of the published Medicaid fee schedule for the same services and supplies. A.5368 was introduced in the State Assembly on Feb. 16 and S.5118 was introduced in the State Senate on Feb. 24. “This legislation is critically needed to ensure...

CMS, Complex Rehab, Durable Medical Equipment (DME), Managed Care Organizations (MCOs), Medicaid


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Virginia: Stakeholders seek to restrict Medicaid MCOs

August 27, 2020HME News Staff

RICHMOND, Va. - Stakeholders in Virginia are lobbying for a budget amendment that would help to safeguard DME providers by ensuring that Medicaid MCOs can't force contract terms that are unfair or unequitable, according to ACMESA. HB5005 482.20 #59h would place a threshold on how much MCOs can discount off the Virginia Medicaid fee schedule, helping to ensure that patients have access to equipment and services, and to protect providers from additional rate reductions. Stakeholders argue the amendment,...

Managed Care Organizations (MCOs), Medicaid, Rate cuts, threshold


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Not all MCOs are hot on Medicaid

May 17, 2019Liz Beaulieu, Editor

YARMOUTH, Maine - The upward trajectory of MCOs managing state Medicaid programs has hit a kink.Despite 79% of respondents to a recent HME Newspoll reporting that MCOs manage the Medicaid program in their states, 54% report one or more have exited the market in the past year.“They can't make money at it, so they don't want to be in that business going forward,” said Paul Harbaugh of Avera Home Medical Equipment, which serves patients in North and South Dakota, Minnesota, Iowa and Nebraska.MCOs...

Home Medical Equipment (HME), Managed Care Organizations (MCOs), Medicaid


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KMESA calls for support of MCO-related bill

February 14, 2019HME News Staff

FRANKFORT, Ky. - KMESA is asking HME providers in Kentucky to support HB 224. Introduced last week by State Rep. Kim Moser, the bill seeks to ensure that DME providers are paid at the rate set by Kentucky Medicaid. It would also require that, should a patient transfer from one Medicaid managed care organization to another, services that are currently being provided under a PA will be honored by the new MCO; and require MCOs to cover, at a minimum, the same quantities of supplies covered under the...

Kentucky, KMESA, Managed Care Organizations (MCOs), Provider


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