Tag: prior authorization complex rehab
What are CMS's plans for prior authorization demonstration
January 23, 2018Liz Beaulieu, Editor
WASHINGTON - A Medicare demonstration project requiring prior authorizations for standard power wheelchairs in 19 states expires this August.“We've had some initial conversations with Medicare with regard to what they plan to do,” said Seth Johnson, senior vice president of government affairs for Pride Mobility Products. “We remain hopeful that it will become a permanent part of the program.”CMS's last action on the demo: In July 2015, the agency extended the demo through...
Prior auths become law of land for two complex rehab codes
July 7, 2017Liz Beaulieu, Editor
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.Providers in Illinois, West Virginia, Missouri and New York have already had to submit PARs for K0856 and K0861 for dates of delivery on or after March 20 as part of the first phase of the process.CMS officials told listeners the same rules apply in this second phase of the process, with one exception....
Ahead of expansion, PA process runs smoothly
June 9, 2017Liz Beaulieu, Editor
WASHINGTON - CMS plans to expand a prior authorization process for two complex rehab codes nationwide on July 17 and the agency, for the most part, has the blessing of industry stakeholders.CMS flipped the switch on a PA process for K0856 and K0861 in Illinois, West Virginia, Missouri and New York in March.“From what I'm hearing from our members, it's going smoothly,” said Don Clayback, executive director of NCART. “From the start, we've been supportive of prior authorizations,...