AAHomecare Starting a Payer Relations Council

Association also approaching completion of state-level legislation and regulatory toolkit to help industry advocates.

The American Association for Homecare will be launching a Payer Relations Council that will focus on non-Medicare payer relations, such as Medicare Advantage, Medicaid, Medicaid Managed Care Organizations and commercial plans.

The high-level committee will identify current and future payer relations issues impacting providers across the country, and then educate providers about those issues and help them address those issues, according to Laura Williard, vice president of Payer Relations for AAHomecare.

The Payer Relations Council will build on the successes seen by the association’s other councils, such at the Regulatory Council, which combines different stakeholders from across the industry to engage in a collaborative effort.

“That combined effort is what has made a real difference for the DME industry,” Williard said. “So my goal has been to develop that same thing but for a payer relations strategy.”

The council will include a maximum of 30 members comprised of providers of varying sizes, geographies and product types. While its membership is primarily providers, the council will include some participation from vendors, and organizations like the state associations and VGM. Also, it will likely coordinate with AAHomecare’s State Leaders Council.

AAHomecare will hold a Payer Relations Council strategic planning day on Aug. 27 to develop industry payer relations goals for 2020, as well as long-term agenda items, according to Williard. From that point, the council will hold four quarterly, in-person meetings.   

State Legislation and Regulatory Toolkit

Following that drive to coordinate efforts across the various states, AAHomecare’s State Legislative and Regulatory Workgroup is approaching completion of a State Legislative And Regulatory Resource Toolkit.

Currently a 15-page document, the toolkit provides resources for successfully lobbying on behalf of state initiatives, said David Chandler, director of Payer Relations for AAHomecare.

“Within this toolkit, we have a broad set of issues that we’re experiencing across the country,” he said. “And then we’ve put together tools for advocacy, such as steps for having effective meetings with state legislators.”

Also, the toolkit includes a flowchart that helps state-level HME advocates determine the best way to address issues, and whether or not those issues should be addressed at the regulatory or legislative level.

A large portion of the toolkit is dedicated to consistent legislative language for various topics, such as establishing a rate floor, preventing audits on prior approved items for medical necessity, consistent medical policy within the MCO plans, or how manually priced items should looks, for example. The toolkit also shows in which states these various pieces of legislative language have been used and whether or not they were successful. 

“We think this will provide a step-by-step tool for various state leaders to take and march with,” Chandler explained.

While AAHomceare doesn’t have an exact release date for the toolkit, it is nearing finalizing the document.

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.


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