Payer Update, November 2020

Payer Update

Payer Update: 35 and Growing!
By Jeff Blake

As many of you know we have been working the last 18 months to develop and implement the Hemophilia Alliance Network Services (HANS) HTC PPO Network. We now have 35 signed PPO agreements with our HTC members, and we are working with several other member HTCs to increase the number of signed PPO agreements. Imagine if all our member HTCs signed the agreement – we could offer the very best network of HTCs to payers.

We now have 4 HANS Agreements with Payers that our members that have signed our HANS PPO agreement can participate in. The agreements are with:

CareSource Archimedes Rx
AscellaHealth Security Health Plan

These agreements and individual letters of agreements (LOAs) have brought back millions of units to the participating HTCs pharmacy programs which has strengthened the sustainability of the programs. In addition, we continue to work with insurance brokers/consultants, third party administrators (TPAs), self-insured employers, stop-loss/reinsurance carriers, and other payers. Based on these payer relationships, we now have more than 40 active payer opportunities to bring back more business to our member HTCs.

We have accomplished a lot, but there is so much more that we can do. Below is a summary of the results of bringing business back to HTC pharmacy programs since 2018.

Total new units 1/1/2018 – 10/31/2020 36,685,000
Current opportunities/potential new units 64,381,000

The Hemophilia Alliance Team is excited about our efforts with payers to support our members and we look forward to working with more member HTCs to expand our HANS efforts to help you grow your pharmacy business to support your HTCs operations and programs.

If you have not signed a HANS PPO Agreement, now is the perfect time. Please contact a member of the Hemophilia Alliance Team to learn more about HANS or how we can assist in solving your payer issues.

Also in this Issue…

Notes from Joe
· The Light at the End of the Tunnel

Legal Update
· HHS Continues Its “Regulatory Sprint”

Washington Update

Notes from the Community
· Plasminogen Deficiency Foundation Launched

Alliance Update
· Announcing Our New Board Member
· 2021 Meeting Schedule