NEMEP Session # 6 MANAGED CARE CONTRACTING

Thursday, December 10th at 1pm ET

NEMEP Session # 6
MANAGED CARE CONTRACTING
  Jeff Baird, JD, Brown & Fortunato

"Managed Care Contracting Made Simple ”

In the past, DME Supplier’s payor mix consisted entirely of Medicare & Medicaid (“FFS”).  However, this is no longer the case.  The market is more competitive & industry initiatives have forced suppliers to expand

payor mix.  This program will discuss the challenges facing suppliers as they enter MC arena, including (i) the refusal of an MC Plan to allow new suppliers on their panels; (ii) coverage & reimbursement policies

that are different than FFS programs; (iii) the prohibition against selling cash items to “covered lives” under the Plan; (iv) a “take it or leave it” attitude by the Plan; and (v) Plans entering into “sole source” and

 “preferred supplier” arrangements.  Equally as important, the program will discuss the steps that suppliers can take to overcome these challenges