Subscribe to RSS - prior authorization

prior authorization

CMS answers questions about prior auth process


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

CMS extends PMD demo


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’

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

Staying paid

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


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


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


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


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’

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.

CMS on PMD demo: Denials increase, spending drops


WASHINGTON – Stakeholders say CMS’s recent update on the PMD demo doesn’t paint the whole picture.