Will the PMD demo expire?

Friday, May 29, 2015

WASHINGTON – A demo project requiring prior authorizations for power mobility devices has been hailed a success by all those involved, yet it’s due to expire Aug. 31.

“We haven’t talked to anyone who’s opposed to it,” said Seth Johnson, vice president of government affairs for Pride Mobility Products. “The Hill likes it. CMS likes it. Providers like it. Consumers like it.”

The demo kicked off in seven states in 2012 and expanded to an additional 12 states in 2014. In its most recent status update, CMS said monthly spending on PMDs in the original seven states fell 69% from September 2012 to June 2014, resulting in $9 million in savings.

Stakeholders are largely at a loss as to why there are no plans yet to continue the demo, or for that matter to expand it to all PMDs and accessories, and to all states.

“We’ve had conversations with CMS as to why, particularly with PMDs since they’re already doing over half the country, they haven’t rolled out prior authorizations nationwide,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “We haven’t been able to get a clear answer.”

Stakeholders have heard that CMS would like to continue the demo, but in the absence of any details from the agency, they’re working to secure its viability through legislative means. 

“We’ve been working with a couple of legislators to get legislation introduced in the early part of June to expand the demo,” Johnson said. “We’re not taking anything for granted.”

The demo’s expiration date may still be three months away, but it’s a real concern, stakeholders say.

“All these folks who have been doing prior authorizations and liking it—to have that disappear would be a huge disappointment,” Bachenheimer said.