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Tag: medicaid


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State news: Texas, Ohio

April 13, 2021HME News Staff

AAHomecare has worked with TexMEP and other stakeholders to get three bills introduced in the state legislature on rate stability and patient access to quality HME. HB 3679 would require Medicaid managed care organizations to reimburse providers at no less than 95% of the state’s published Medicaid DME fee schedule. HB 3678 would update the insurance code to support Medicaid continuity of care and patient choice language, and ensure adequate reimbursement. HB 3677 would amend...

aahomecare, managed care, medicaid


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Providers push back against cuts by MCOs 

News

Providers push back against cuts by MCOs 

March 12, 2021Theresa Flaherty, Managing Editor

COLUMBIA, S.C. – HME providers are fighting large managed care organizations that are increasingly pushing into more states and offering reduced reimbursement rates, say industry stakeholders.  The straw that’s breaking the camel’s back: The COVID-19 pandemic pushing the cost of doing business even higher, says Craig Douglas, vice president of payer and member relations for VGM.  “Acquisition...

aahomecare, Centene, Craig Douglas, Laura Williard, managed care, medicaid, VGM


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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...

complex rehab, dme, fee schedule, managed care organizations, medicaid


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CMS approves block grant waiver in Tennessee 

January 14, 2021HME News Staff

NASHVILLE, Tenn. – CMS has approved Tennessee’s request for a block grant waiver for its state Medicaid program, TennCare, AAHomecare reports. The new program will allow TennCare to administer Medicaid with less oversight from the federal government, increasing its flexibility. The new block grant waiver – known as TennCare III – came after the General Assembly passed a law in 2019 directing Gov. Bill Lee’s administration to negotiate...

medicaid, TennCare, Tennessee


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State news: Minnesota pauses recoupments 

December 29, 2020HME News Staff

ST. PAUL, Minn. – The Minnesota Department of Human Services has temporarily suspended its plans to recoup payments where the state Medicaid program paid more for DME than Medicare did in 2018 per the 21st Century Cures Act, MAMES reports. In December, the state association received a letter from the state saying, “DHS has temporarily suspended our processes for these recoveries.” MAMES believes the pause is due to the current public health emergency. “There...

21st Century Cures Act, medicaid, recoupments


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Mobility

Complex rehab update: Medicaid worries, legislative hopes

November 20, 2020Liz Beaulieu, Editor

BUFFALO, N.Y. - State Medicaid programs are keeping a close watch on the severity of the COVID-19 pandemic and the progress of relief-related packages in Congress as they make their budget plans for 2021, says Don Clayback. That's the takeaway that Clayback, the executive director of NCART, had after attending the virtual meeting of the National Association of Medicaid Directors earlier this month. “With all of the COVID-19 expenses going on, along with the drop in revenues at the state level,...

complex rehab, coronavirus outbreak, Don Clayback, medicaid


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Providers

Scott Markovich is on the hunt for Medicaid savings

September 30, 2020Theresa Flaherty, Managing Editor

HARTFORD, Conn. - With many state Medicaid programs facing increased enrollment but decreased budgets, the timing of CareCentrix's recent expansion into the Medicaid managed care market couldn't be better, says Scott Markovich. “The largest pot of money is Medicaid for most governors,” said Markovich, the company's new general manager of Medicaid. “We are going to see a shifting of funds, as more people tax the system. They will transfer the risk to health plans and that's where...

CareCentrix, medicaid, Scott Markovich


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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,...

MCOs, medicaid, rate cuts, threshold


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News

North Carolina rate protects DME

July 7, 2020HME News Staff

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.The bill, a year in the making by groups like ACMESA and AAHomecare, prohibits managed care organizations from setting rates below the state's Medicaid fee-for-service rates for DME.“ACMESA's strong relationship with AAHomecare enabled us to learn from the problems experienced in other states as they rolled out their MCO programs,” said Craig...

managed care, medicaid, North Carolina, rate protection


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Provider relief updates: PPP, Medicaid

July 7, 2020HME News Staff

President Trump has extended the deadline for small businesses to apply for a loan from the Paycheck Protection Program to Aug. 8. The original deadline was June 30, but as of that date, there was $130 billion still available in funding. On July 4, President Trump signed a bill that would extend the deadline to Aug. 8. “Any business that meets the qualifications for the program but has not yet applied now gets a second chance at the popular program,” VGM Government Relations stated in...

medicaid, Paycheck Protection Program, provider relief


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