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prior authorization

CMS announces first codes up for PA process

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12/21/2016

WASHINGTON – CMS has announced the first two codes that will require prior authorization as a condition of payment.

CMS answers questions about prior auth process

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02/02/2016

WASHINGTON – CMS has published an FAQ for the prior authorization p

CMS extends PMD demo

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07/14/2015

WASHINGTON – CMS will extend the PMD demo for an additional three years, until Aug. 31, 2018, according to a notice that the agency expects to publish in the Federal Register tomorrow.

Bill provides ammo for audit reform

‘Hopefully it will spur CMS to do something more quickly’
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05/29/2015

WASHINGTON – HME stakeholders have accomplished the first of two goals in their bid to reform Medicare’s audit program.

Staying paid

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Monday, May 18, 2015
Don Chrysler

I would like to respond to Doug Harrison’s letter to the editor "Warning shot" (see below).

Demo set to arrive in 12 new states

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09/12/2014

YARMOUTH, Maine – CMS’s PMD demo is set to arrive in 12 new states in just a few weeks and, for the most part, providers are welcoming it with open arms.

CMS dishes on new prior auth proposal

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06/20/2014

WASHINGTON – CMS officials last week acknowledged that some providers feel “angst” about prior authorizations (PAs), but they say, given a chance, the process will prove beneficial.

Providers debate prior auth proposal

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06/13/2014

YARMOUTH, Maine – A majority of HME providers welcome the idea of prior authorizations for certain DME, but they say Medicare’s proposed timeline for returning decisions is unreasonable.

CMS eyes expansion of prior auths

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05/23/2014

BALTIMORE – CMS may implement prior authorizations for certain durable equipment, it announced May 22.

Private payers put squeeze on sleep

‘They are trying to decrease sleep studies’
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04/04/2014

YARMOUTH, Maine – Since the first of the year, CPAP providers have seen an onslaught of policy changes among private insurers that have made it harder for them to do business.

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