AAHomecare reports the following 6/04/2018:
On Friday, CMS released CMS-6080-N, “Medicare Program; Update to the Required Prior Authorization List of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items That Require Prior Authorization as a Condition of Payment.”
This rule moves the HCPCS in the PMD PA Demonstration to the national Prior Authorization program beginning September 1, 2018 and expands it nationwide. The PMD PA Demonstration was slated to end on August 31, 2018, leaving PMD suppliers in 19 states uncertain about the future of this favored program. AAHomecare has been working with CMS to get the Demonstration implemented nationally and is pleased to see this announcement. CMS will be publishing a subregulatory communication regarding this transition at a later time; AAHomecare will notify membership when the subregulatory guidance is released.
See full details here, including a list of the 31 HCPCS Codes covered.
As we recently noted, the Government Accountability Office had released a report touting cost savings achieved by various Medicare prior authorization demonstration programs since 2012, which included a recommendation to continue these programs.