PMD demo details still up in the air

Friday, August 10, 2012

WASHINGTON – With just a couple of weeks to go before the start date for the power mobility device demonstration project, there are still a lot of placeholders in the latest draft of the operational guide.

The biggest: a placeholder that refers to a pending change to the program integrity manual (PIM) regarding templates for physicians.

"We've created a section there to describe the tools and interfaces that can assist physicians and practitioners in documenting a progress note," Melanie Combs-Dyer, deputy director of CMS's provider compliance group, told listeners during an Open Door Forum last week. "It refers readers to a PIM section that does not yet exist but will shortly."

Industry stakeholders have been pushing CMS to include, as part of the seven-state demo, a template to guide physicians through the documentation requirements.

Other placeholders in the guide refer to accessories (will they or won’t they be included in the demo?), upgrades (how will prior authorizations work when patients want more expensive PMDs than Medicare will agree to cover?), and a definition for late entries (review contractors will consider late entries to be part of a medical record if they are made within "a few days" of the visit, but providers want to know what "a few days" means).

Dyer stated she expects all the placeholders to be replaced with guidance by the next forum, set for Aug. 29.

With the demo set to start Sept. 1, stakeholders expressed concerns about having enough time to educate staff and physicians.

"There's still some significant areas that are not complete yet and we're three weeks away from implementation," said Don Clayback, executive director of NCART, during last week’s forum. "All along we've been expressing concern about education and time to prepare and the fact that some of this is still in development may make things more difficult."

Dyer replied, "We will certainly try to get that out as soon as possible."

View the newest draft at