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prior authorization

Prior auths become law of land for two complex rehab codes

Process for K0856, K0861 began in four states in March
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07/07/2017

WASHINGTON – HME providers in all states must begin submitting prior authorization requests for two complex rehab codes starting July 17, CMS officials confirmed during a Special Open Door Forum on July 6.

Prior auth legislation could nudge CMS forward

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05/19/2017

WASHINGTON – AAHomecare hopes a new bill will be the legislative push for CMS to speed up a prior authorization process for certain HME.

Rep. Blackburn introduces prior auth legislation

Stakeholders applaud the move, believe CMS isn’t moving fast enough to require PA for broader spectrum of HME
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05/17/2017

WASHINGTON – Rep. Marsha Blackburn, R-Tenn., has introduced legislation that would require prior authorization for certain high priced HME, AAHomecare reported this morning.

Prior authorization: CMS clarifies stance on accessories

Agency also agrees to change delivery timeframe
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03/22/2017

WASHINGTON – During a second Special Open Door on March 21, CMS officials gave examples of what accessories are covered under a new prior authorization process for K0856 and K0861 power wheelchairs.

Accessories remain gray area for prior authorization process

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03/17/2017

WASHINGTON – CMS officials spent much of a Special Open Door Forum on March 16 discussing whether or not accessories will be covered under a new prior authorization process for two complex power wheelchair codes.

It’s a bumpy start for prior authorizations

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03/10/2017

WASHINGTON – CGS and Noridian have begun accepting prior authorization requests for K0856 and K0861, but complex rehab providers say they still don’t have all the information they need to comply with the program.

CareCentrix requires repeat authorizations for oxygen

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02/24/2017

HARTFORD, Conn. – A recently announced change to CareCentrix’s authorization process for oxygen patients covered under a Medicare Advantage plan has stakeholders scratching their heads.

Stakeholders await instructions on PA process

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01/27/2017

WASHINGTON – The cancellation of a Jan. 26 Special Open Door Forum on the upcoming prior authorization process for two complex rehab codes means industry stakeholders will have to wait longer to get their concerns and questions addressed.

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

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