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Managed Care Contracts: How to Negotiate and How to Access Another Supplier’s Contract

Managed Care Contracts: How to Negotiate and How to Access Another Supplier’s Contract

Tuesday, November 19, 2019 ~ 2:30PM - 3:30PM

Webinar Presented by Jeff Baird, ESQ. of Brown & Fortunato

At the end of the day, DME suppliers primarily serve the elderly (Medicare) and those on the lower end of the socio-economic scale (Medicaid). Both the Medicare and Medicaid programs are gravitating towards “managed care.” Approximately 35% of Medicare beneficiaries are signed up with Medicare Advantage Plans, while approximately 70% of Medicaid beneficiaries are signed up with Medicaid Managed Care Plans. These percentages are increasing. 

Medicare and Medicaid Plans work essentially the same way: (i) the government health care program contracts with a “Plan” that is owned by an insurance company; (ii) the Plan signs up patients; (iii) the Plan signs contracts with hospitals, physicians, DME suppliers and other providers…these providers will take care of the Plan’s patients; and (iv) the government program pays the Plan that, in turn, pays the provider. 

Increasingly, DME suppliers will be asked to sign managed care contracts. In so doing, the supplier needs to be careful. Not only must the contract provide sufficient reimbursement to the supplier, but the contract will have some “trap” provisions that may be harmful to the supplier. This program will discuss the most important provisions that are contained in managed care contracts. The program will discuss how the supplier can negotiate with Plans; and the discussion will point out the provisions that are often non-negotiable and the provisions that are open to negotiation.

Price $99 | Non-Member $129

Online registration is available through the link above. Please contact Cherie Newell at cherien@aahomecare.org or 202-372-0752 for assistance. Non-members are invited to create an account for future registrations.  A registration form is available for download if preferred.

 

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