CMS answers questions about prior auth process

Tuesday, February 2, 2016

WASHINGTON – CMS has published an FAQ for the prior authorization process for DME. A number of the questions address the agency’s “master list” of 135 products for which a prior authorization could be required. Those products include CPAP devices, semi-electric hospital beds, manual wheelchairs and oxygen concentrators. Stakeholders are still waiting for sub-regulatory guidance on when prior authorizations will be required and for what products. CMS published its final rule for the prior authorization process on Dec. 30, with an effective date of Feb. 29.