Third Party Administrators’ Impact on Medicaid Managed Care
The involvement of third-party administrators in Medicaid MCOs is starting to look like it will go from bad to worse for HME providers. What do providers need to know and what should they do?
- By David Kopf
- Oct 30, 2019
Laura Williard, vice president of payer relations for the American Association for Homecare, speaking at the Oct. 22 Medtrade Washington Update.
The world of Medicaid Managed Care Organizations (MCOs) is growing more complex with the involvement of third-party administrators (TPAs), and as the edition of the HME Business Podcast shows, it’s going to get even more complicated.
In episode 018, the second of the three special, post-Medtrade episodes, Laura Williard, vice president of payer relations for the American Association for Homecare, discusses how TPAs are increasingly getting involved in MCOs and often run right past protections for providers. Furthermore, there have been some business developments in the MCO-TPA world that are compounding this problem.
Williard provides all the details on the situation; sheds light on what’s being done to combat this problem; and outlines what providers should do to protect their businesses.
Download the episode on iTunes, Stitcher or Google Play, or listen to the episode here:
In the previous episode, the first of the three special, post-Medtrade episodes, Jay Witter, senior vice president of public policy for AAHomecare, discussed the work done thus far to convince CMS to reverse its worrying course of action. My conversation with Jay explores what HME providers should know about the issue and the pending legislation, and how they can help protect this benefit and the patients that need it.
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David Kopf is the Executive Editor of HME Business and DME Pharmacy magazine. Follow him on Twitter at @postacutenews.