Updates for Homecare's HME Payor Coverage

(From the June 2019 Issue of MedStat 

Earlier this year, Buckeye Community Health Plan (BCHP) carved out coverage for Nationwide Children's Hospital Homecare HME products. Previously, these patients were covered through Homecare’s in-network provider agreement with BCHP. The change in coverage resulted in a variety of challenges for these families whose children were receiving their HME supplies or equipment from Homecare.

Nationwide Children's Hospital’s Payor Relations and Buckeye Health renegotiated and updated the provider agreement for HME to cover all patients residing in the Partners for Kids (PFK) service area. The agreement once again covers the majority of HME dispensed by Homecare for patients residing in the PFK service area. The only exception is Richland County, which is in HME’s service area, but not listed as a PFK county.

As a reminder, all HME referrals require a signed physician order. Help Homecare remain Medicaid compliant and provide best patient outcomes by submitting a signed physician order for HME supplies at the time of referral. This requirement applies to all supplies and equipment that will be billed through Medicaid or insurance. Payors will not reimburse for any supplies (i.e. braces, helmets, feeding supplies) or equipment (pumps or bili-blankets) without a physician signature on the order submitted for reimbursement. 

Visit Home Care Resources for Professionals for Medicaid forms and DME referral coverage information. Get updated inventory listings at Home Medical Equipment. Any questions or concerns please call (614) 355-1100.