Florida Announces Medicaid Managed Care Awards

TALLAHASSEE, FL – Florida’s Agency for Healthcare Administration recently announced their intention to award Statewide Medicaid Managed Care contracts to five companies:

• Florida Community Care – Regions A, B, C, D, I
• Humana Medical Plan – Statewide
• Simply Healthcare Plans – Statewide
• South Florida Community Care Network, dba Community Care Plan – Regions E, F, G, H, I
• Sunshine State Health Plan – Statewide

The new contracts will take effect on Jan. 1, 2025. According to a related announcement, the Agency is giving respondents who did not receive an award an option to challenge the result through Apr. 17.  Find more information on the awards here, along with maps of the above-referenced regions.

Michigan Awards Medicaid Contacts to Nine Plans

LANSING, MI – The Michigan Dept. of Health and Human Services has awarded contracts for Michigan’s Medicaid health plans. The nine health plans receiving contracts include: Aetna Better Health of Michigan, Blue Cross Complete of Michigan, HAP CareSource, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, Priority Health Choice, United Healthcare Community Plan, and Upper Peninsula Health Plan.  You can see details on contracts awarded by region here.

The five-year contracts include three, one-year optional extensions and go into effect Oct. 1, 2024.  See Michigan’s regional map here.

Texas Medicaid Announces MCO Contract Awards

AUSTIN, TX – Texas Medicaid recently announced an intent to award MCO contracts for the STAR+PLUS Medicaid population.  The anticipated start date of the new contracts is Sept. 1, 2024.  Contracts run for six years with three two-year renewal options.  The contracts awarded were:

• United Healthcare Community Plan of Texas – Bexar, Central Texas, Dallas, Harris, Hidalgo, Northeast Texas, Tarrant and Travis Service Areas
• Molina Healthcare of Texas – Bexar, Dallas, El Paso, Harris, Hidalgo, Jefferson, Northeast Texas and Tarrant Service Areas
• Superior Health Plan  – Central Texas, Dallas, Hidalgo, Lubbock, Nueces, Travis and West Texas Service Areas
• Amerigroup Insurance Company – Jefferson, Lubbock, Nueces and West Texas Service Areas
• Community First Health Plans – Bexar Service Area
• El Paso Health – El Paso Service Area
• Community Health Choice Texas – Harris Service Area

Superior Health Plan was expected to file a protest in response to losing contracts in several service delivery areas. More information can be found on the Texas HHS Procurement Opportunities page.

AAHomecare To Host CRT Hill Day In September

WASHINGTON, D.C. – Support the “Choices for Increased Mobility Act” and complex rehab issues this Fall! AAHomecare encourages the CRT community to make plans to attend a CRT-focused fly-in in Washington, DC this September (specific date to be announced soon!).

This Hill Day will be an opportunity for members of the manufacturing and supplier community to showcase the technology and equipment currently utilized by consumers, the work that goes into fitting a consumer, and how current policy falls short of meeting the needs of consumers.

A primary focus of the legislative visits during the September CRT Fly-In will be securing support for passage of H.R. 5371, the “Choices for Increased Mobility Act”, which would improve consumer access to titanium and carbon fiber wheelchairs.

Medicare policy changes in 2016 drastically altered how these upgraded materials are categorized and individuals with disabilities have been significantly restricted in access to these important technologies as a result. HR. 5371 aims to restore access not only for Medicare beneficiaries but also for others enrolled in plans that follow Medicare policy and coding.

If you are interested in participating in this CRT-focused Hill Day, please reach out to Alexis Ward, [email protected], to be added to the list for invitation details.

HIGLAS Update Provides Clarity on Remittance Advice

WASHINGTON, D.C. – The industry has long grappled with the challenge of Treasury offsets impacting supplier payments, a concern that has been actively addressed through collaboration with the DME MACs. For years, suppliers received recoupments without clear identification, leaving them in the dark about the source and purpose of these offsets. The issue stemmed from offsets being tied to Tax ID numbers rather than specific NPI, leading to confusion and difficulty in reconciling payments.

However, as of this month, CMS has taken significant steps to address this issue by implementing changes to the Healthcare Integrated General Ledger Accounting System (HIGLAS). Starting April 1, the remittance advice will include the PTAN associated with the location responsible for the deduction. These changes involve updating instructions to the Viable Information Processing Systems (ViPS) Medicare System (VMS) regarding the utilization and reporting of Provider Level Adjustment (PLB) codes on the Remittance Advance (RA). The primary goal of these modifications is to establish consistency and uniformity in reporting practices across the board.

These changes offer a permanent solution to the challenges faced by suppliers in reconciling Treasury offsets from their Medicare payments by ensuring that offsets are correctly applied to the corresponding NPI and claim. This positive development not only streamlines administrative processes but also provides much-needed clarity and transparency for suppliers.

This welcome change will provide additional documentation for suppliers to help accurately reconcile recoupments to the correct NPI or supplier entity. You can find a DME MAC article on the change here.

Maine Legislature Considers Sales Tax Exemption

AUGUSTA, ME – If you are a resident of Maine or do business in the state, AAHomecare encourages you to reach out to your key leaders including members of the Appropriations and Financial Affairs Committee asking for support of LD 1184 (Jackson). This legislation would exempt durable medical equipment, breast pumps, and mobility enhancing equipment from sales tax in the budget.

AAHomecare has set-up a Voter Voice campaign here that makes it quick and easy to take action.

You are encouraged to add information to the message about your company’s work providing medical equipment and supplies in Maine. Please also share this link with your colleagues and contacts and ask them to take action.  You must have a Maine home or business address to participate.