Tag: Payers
In brief: VGM’s state payer hub, CMS’s fraud war room, Drive Medical’s IQ
July 31, 2026HME News Staff
WATERLOO, Iowa – VGM Government Relations has launched a State Payer Resources web page designed to give DMEPOS providers one place to find state-specific payer and regulatory information.
The centralized hub includes frequently used resources such as:
Medicaid policy manuals
Provider enrollment information
DMEPOS licensure requirements
State Medicaid contacts and websites
Links to state DME associations
VGM says the web page is intended to help providers more quickly...
AAH boosts rate strategies with new portal
January 10, 2025Liz Beaulieu, Editor
WASHINGTON – AAHomecare’s new Payer Transparency Portal is another tool for the HME industry to fight low reimbursement rates from commercial insurers, says Laura Williard.
The portal, which is free to AAHomecare members, features data from more than 60 major commercial insurers, helping providers to understand payment rates and trends.
“They can use the data to see where they are in the percentiles and build their story on what programs and processes they have...
Rehab Medical has new ‘eyes’ on payers
January 10, 2025Liz Beaulieu, Editor
INDIANAPOLIS – Rehab Medical has sharpened its focus on regulatory and funding issues by adding Michael Farrell, formerly of UnitedHealthcare and Optum, to its executive team to “protect” the company’s growth in the complex rehab technology market.
The company in December named Farrell, who has more than 15 years of experience in the broader health care industry, as vice president of regulatory and funding, a newly created position.
“Every provider...
AAH to launch Payer Transparency Portal
December 16, 2024HME News Staff
WASHINGTON – AAHomecare has announced a new benefit for its HME provider members in 2025: the Payer Transparency Portal.
The association says the portal will provide:
Nationwide payer insights: Tap into data from more than 60 major commercial insurers to understand reimbursement trends and payment rates.
Competitive benchmarking: Compare your reimbursement rates to those of your peers and competitors.
Smarter negotiations: Leverage detailed data segmented by payer,...
Heard at the Summit: Scaling hospital-at-home, understanding payers & weaponizing data
November 1, 2023Liz Beaulieu, Editor
CHARLOTTE, N.C. – The administrator of Atrium Health’s hospital-at-home program provided insight into its partnership with Best Buy Health and more at the HME News Business Summit last week in Charlotte.
Colleen Hole said the partnership makes the best use of the strengths of Atrium Health, a Charlotte-based health system serving patients at 40 hospitals and hundreds of care locations, and the health division of the big box retailer.
“We’re good at operations;...
AAH updates: Anthem, UnitedHealthcare, MACPAC
August 27, 2020HME News Staff
AAHomecare has doubled down on Anthem, sharing with the payer several examples of product cuts that highlight disparities between its new rates and Medicare rates both inside and outside competitive bidding areas, as well as the average rates currently in effect under the CARES Act. Earlier this summer, the association had expressed concerns about the cuts to Anthem, and the payer responded that the cuts “better align rates to state and local DME market dynamics.” In its subsequent response,...
McKesson puts the partnership in payer relations
November 27, 2019Tracy Orzel
ROCK HILL, S.C. - McKesson recently hosted its fifth provider roundtable in Rock Hill, S.C., to discuss the importance of payer relations on the HME industry's future. “HME is a small percentage of what payers pay for, but it saves a lot of money in other areas of health care, because it's less expensive to have a patient home than in an acute care or long-term care facility,” said Ashley Latva, account manager, HME, North Carolina, McKesson. “So we want payers to see the value...
David Chandler on MCOs: 'We need to transform school of thought'
April 1, 2019Liz Beaulieu, Editor
WASHINGTON - AAHomecare will grow its payer relations team in April to include David Chandler as its director of payer relations.Chandler is director of reimbursement and government affairs for Liberty Medical Specialties based in Whiteville, N.C.; treasurer of the Atlantic Coast Medical Equipment Services Association; chairman of the Medicare Jurisdiction C Advisory Council; and a member of AAHomecare's Regulatory Council and State Leaders Council. He also serves on the North Carolina Board of Pharmacy/DME...
VGM helps protect sleep contract
March 29, 2018HME News Staff
WATERLOO, Iowa - The VGM Group has helped providers in Maryland, Washington, D.C., and Virginia beat back CareFirst BlueCross BlueShield's plans to reduce the number of providers in its network that are authorized to provide CPAP equipment. The insurer planned to limit its network to a few providers after Feb. 15, 2019. When VGM heard from members about CareFirst's decision, it filed a complaint with the Maryland Insurance Administration and after some back and forth CareFirst agreed to allow...
Unfortunately, perception is reality
February 24, 2015Liz Beaulieu, Editor
I had conversations this week with two very smart women, Tammy Zelenko and Michelle Templin, about how referral sources and payers have no idea what HME providers actually do.
I expect this of most lawmakers, but referral sources and payers?
Templin, vice president of strategic development for Managed Health Care Associates, interacts with a number of payers in her work to promote the company's ACO Network, a national network of post-acute providers.
“The perception, from the payer perspective,...