The Centers for Medicare & Medicaid Services will hold a Special Open Door Forum on Feb. 23rd from 3 pm to 4:30 pm EST to provide an opportunity for suppliers and providers to ask questions about the upcoming Prior Authorization of Power Mobility Devices Demonstration.
The Centers for Medicare & Medicaid Services (CMS) will conduct this demonstration to implement a prior authorization process for certain medical equipment for Medicare recipients who reside in seven states with high populations of fraud- and error-prone providers (California, Florida, Illinois, Michigan, New York, North Carolina, and Texas). This step will help ensure appropriate payment for certain medical equipment with a high error rate.
The demonstration also will help ensure that a beneficiary’s medical condition warrants their medical equipment under existing coverage guidelines. Moreover, the program will assist in preserving a Medicare beneficiary’s right to receive quality products from accredited suppliers.
In response to comments received from stakeholders about the Prior Authorization of Power Mobility Devices (PMDs) demonstration, CMS has made a number of modifications to the Prior Authorization of PMD demonstrations:
- CMS has completed a separate Paperwork Reduction Act (PRA) notification for this demonstration
- CMS has removed the 100% pre-payment review phase (formerly Phase 1)
- CMS will allow suppliers to perform the administrative function of submitting the prior authorization request on behalf of the physician/treating practitioner
- CMS anticipates the start of this demonstration will be on or after June 1.
To read more about the demonstration, visit http://go.CMS.gov/PAdemo. Participants may submit questions prior to the Special Open Door Forum to PAdemo@cms.hhs.gov.