Virginia: Stakeholders seek to restrict Medicaid MCOs
By HME News Staff
Updated Thu August 27, 2020
RICHMOND, Va. - Stakeholders in Virginia are lobbying for a budget amendment that would help to safeguard DME providers by ensuring that Medicaid MCOs can't force contract terms that are unfair or unequitable, according to ACMESA. HB5005 482.20 #59h would place a threshold on how much MCOs can discount off the Virginia Medicaid fee schedule, helping to ensure that patients have access to equipment and services, and to protect providers from additional rate reductions. Stakeholders argue the amendment, which reportedly carries a $345,000 price tag, would result in cost savings by preventing more expensive treatments in hospitals and nursing homes. They say the safeguards are needed because 50% of providers in the state have closed since 2010 and only two providers are left to serve more than 700,000 pediatric patients. “This budget amendment ensures that adults and children in all parts of Virginia will have access to ventilators, oxygen, nebulizers, beds and other HME during the pandemic and beyond,” ACMESA stated in a bulletin. “It establishes a fair and equitable playing field for both the MCOs and DME providers. Lastly, it keeps our constituents at home and protects them from the spread of the virus.”
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