Payer Update, June 2021

Payer Update

Hemophilia Treatment Center (HTC) Revenue Cycle Survey Response Reminder
by Kimberly Wolverton Lackman

As we continue our focus on expanding our Revenue Cycle Management services, the HTC Revenue Cycle Survey was distributed on Monday, May 24th. The completion of the Survey will allow us to better comprehend and anticipate the needs of our Member Treatment Centers as well as develop HTC Revenue Cycle Management Best Practices along with insights to assist in expanding our current reimbursement and revenue cycle services.

The Survey is broken into categories representing the different steps in the revenue cycle process. The ten sections encompass multiple choice and open-ended questions including Billing, Collections, Contracting, Credentialing, Billing Barriers, and Reflection. The estimated completion time is 30-45 minutes.

We are extending the deadline to complete the survey. If you have not already completed the Survey, we would appreciate your response but no later than July 23rd. If you have any questions, please reach out to Kimberly Wolverton Lackman, Manager, Reimbursement and Payer Marketing via e-mail at kimberly@hemoalliance.org or phone at 813.400.6710.


Cost of Dispensing Survey: We Need Your Help!

As you have heard and read, Hemophilia Alliance (HA) has committed significant resources to fund a national HTC cost of dispensing survey administered through a national consulting firm, Mercer.

  • The survey is essential to determine a dispensing fee that is more representative of an HTC so Medicaid and other payers can be assured our cost are higher than traditional pharmacies and we provide a better value both in cost and patient outcomes.
  • If we don’t get at least half of our member HTCs to participate then the survey will not be statistically valid and we will not have the necessary data to support a higher dispensing fee with Medicaid and other payers.

While we have been diligent in bringing all the details of the survey to member HTCs, recently some additional questions have been raised:

  • The survey information is private and will be treated as proprietary. The information submitted with be deidentified and not shared with anyone including HA at an identifiable level.
  • Mercer will sign a Non-Disclosure Agreement (NDA) with any HTC that desires to have one executed. You can see the draft NDA here.
  • The survey is detailed and also asks for information on adjuvant services that are provided to hemophilia patients. HTCs may not have well documented data on these additional services and that is perfectly fine. The service data is part of phase two with a goal to target ways you can be reimbursed (these services were often paid from funds generated through dispensing which are no longer available). The payers agree these are valuable and impactful services but don’t not have a mechanism to reimburse for these services, phase two will give them the methodology.
  • If the detail is problematic, Mercer will assist the HTC is sorting out the data OR if the HTC wants to share their operating data reports and aggregate expenses, Mercer will sort it out and put it in the most appropriate categories.

We need your help! Please consider how important adequate reimbursement is to your HTC ’s financial wellbeing and the care you provide to your patients. Send in your completed survey as soon as possible but no later than July 30, 2021.


Also in this Issue…

Notes from Joe
· Working Together to Maintain Gold Standard Care

Washington Update

Legal Update
· HHS Rescinds Advisory Opinion after Court Describes 340B Statute as Ambiguous as to Contract Pharmacies

Alliance Update
· Update on Alliance Data Portal
· Harmony in Hemophilia Update