Home Health & Hospice Week
Prior Authorization Procedure Finalized For DME
CMS has finalized a rule requiring prior authorizations for certain durable medical equipment prosthetics, orthotics, and supplies (DMEPOS) items that are frequently subject to unnecessary utilization.
“The final rule will prevent unnecessary utilization while safeguarding beneficiaries’ access to medically necessary care,” the Centers for Medicare & Medicaid Services says in a release. “The prior authorization process will require the same information necessary to support Medicare payment today, just earlier in the process. It will not create new clinical documentation requirements.”
“Medicare or its review contractor will make a reasonable effort to render an initial prior authorization determination within 10 business days and will make a reasonable effort to render a resubmission prior authorization determination within 20 business days,” CMS adds in its release.
More details are in the rule published in the Dec. 30 Federal Register at www.gpo.gov/fdsys/pkg/FR-2015-12-30/pdf/2015-32506.pdf.
Home Health & Hospice Week
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