New language gives stakeholders new hope

Thursday, July 9, 2015

WASHINGTON - Lawmakers have added new language to the 21st Century Cures Act to extend CMS’s power wheelchair prior authorization demonstration project, much to the relief of stakeholders.

The latest version of the bill would extend the demo through at least Aug. 31, 2018, and expand it to include more states and more products.

“AAHomecare is pleased that Congress supports extending and expanding this successful program," said Jay Witter, senior vice president of public policy, in statement. "Prior authorization, when implemented correctly, will be good for homecare patients, providers, and the American taxpayer."

The demo, which kicked off in seven states in September 2012 and was expandedto an additional 12 states in 2014,is set expire this August.

The demo has been a hit: It saves CMS money (spending on PMDs in the original seven demo states fell from about $12 million in September 2012 to $3 million in June 2014) and gives providers peace of mind that they will get paid.

“All stakeholders really support the program,” said Seth Johnson, vice president of government affairs for Pride Mobility. “The industry supports it, clinicians support it and Medicare supports it.”