Issue link: https://read.dmtmag.com/i/45026
HME NEWS / NOVEMBER 2011 / WWW.HMENEWS.COM KENTUCKY Managed care plans switch terms BY THERESA FLAHERTY, Managing Editor FRANKFORT, Ky. – HME providers here are none-too-happy with the terms of new state managed care contracts, which they say pay as much as 30% less than what was originally agreed upon. Kentucky planned to imple- ment a managed care program for all Medicaid beneficiaries Nov. 1. Three managed care organiza- tions (MCOs), WellCare, Ken- tucky Spirit and Coventry Care, will administer the plans. Cover letters were sent to providers this summer, stating that DME pro- viders would be paid at 100% of the current Medicaid fee sched- ule. However, when the actual contracts arrived, only WellCare said it would pay 100%. Coven- try Cares offered 85%; Kentucky Spirit offered 70%. "Providers are enrolling in these networks because the cover letters said 100%," said Teresa Providers unhappy with lower terms Camfield, executive director of the Kentucky Medical Equipment Suppliers Association. "When the contract comes back, it has the lower rate." The lower Medicaid rates mir- ror private–insurance contracts that the MCOs currently have with some HME providers, said Camfield. Providers can absorb low pay- ment rates when there's only a handful of patients affected, she said, but when you are talking about a larger patient popula- tion—like Medicaid—it's a dif- ferent story. "They can't accept 70% and provide 24/7 care," said Camfield. Adding insult to injury: With three separate MCOs, providers will have triple the work when it comes to Medicaid patients, said provider Alan Grogan. "All the contracts are different, each has a different fee schedule, and there may well be different processes for each," said Grogan, president of Grogan's Healthcare Supply in Lexington. "We've been in contact with the Medicaid liai- son. There's still a lot of unan- swered questions." HME Accreditation. There's a better way. HQAA is the only accreditation provider with coaches to review your standards documentation, an Online Workroom to efficiently manage the process, and the ACT Service to maintain high quality standards between accreditation periods. There's a better way. Switch to HQAA. To get started, visit www.HQAA.org/switch or call 866.909.4722. State News Attendees tee off at MESA event The Medical Equipment Suppliers Association (MESA) hosted more than 150 attendees during its Fall Conference at the Crowne Plaza in Dallas Sept. 13-16. The event featured billing and delivery driver training, and appearances by Medicaid and regulatory agency representatives. But it wasn't all work, no play. Thanks to one of the event's sponsors, DME Train, there was an 18-hole mini-golf course in the exhibitor area. Vendors were at their respective tees, coaching players, initialing their scorecards and lifting flags from holes. Prizes were doled out for holes in one, lowest score and more. Speakers Ty Bello and Vince Crew were the masters of ceremonies at a subsequent reception. 15 Become a Quality Champion.