MS Supply takes on WellCare

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Friday, May 3, 2019

TAMPA, Fla. – MS Supply and Home Health Company, a mom-and-pop provider, has filed a lawsuit against WellCare, claiming the managed care organization owes it more than $1 million.

MS Supply contracted with WellCare to provide DME, complex rehab and home health services to Medicare Advantage patients throughout the state of Florida in 2015, and has received approximately 15 home health referrals and 25 to 30 DME referrals from them a day. Problems didn’t start until 2016, says Farie Sanchez, COO.

“We started noticing glitches,” she said. “We’d send emails saying, ‘Hey, you underpaid us, what’s going on?’”

In addition to underpayments, MS Supply has had money recouped when it shouldn’t have, and had reimbursement for Part A home health services applied to Part B services, says Sanchez.

MS Supply itself is being sued by Health Pro Heritage at Home, a Tulsa, Okla.-based staffing firm that provided services to MS Supply through a subcontracting arrangement. In April, MS Supply added WellCare as a third-party defendant to the lawsuit, filed in the 13th Judicial Circuit Court in Hillsborough County, Fla.

The move was necessary after multiple phone calls, emails and in-person meetings between MS Supply and its attorneys and WellCare failed to resolve the issues, says Sanchez.

“We just keep going back and forth,” she said. “They are playing this delay game and yet we have patients who are suffering and don’t have access to equipment because we can’t service them if we don’t get paid.”

MS Supply, a family-owned business started in 2002 by siblings Manuel and Magdalena Santos, immigrants from the Dominican Republic, had no other options, says Magdalena Santos.

“This hurts us,” she said. “This isn’t $200 or $300. We’re still looking in our books (to see what they owe us). We cannot trust the system.”

In an email to HME News, WellCare, which announced in March that Centene Corp. will acquire the organization for $15.27 billion, said it doesn’t comment on pending legislation.