martes, 5 de agosto de 2014

Home Health, Hospice & DME Open Door Forums Update

Centers for Medicare & Medicaid Services

Centers for Medicare & Medicaid Services

Special Open Door Forum:
Medicare's Expanded Prior Authorization for Power Mobility Devices Demonstration
Tuesday, August 12, 2014
2:00 p.m. - 3:30 p.m. EST
Conference Call only

 CMS will host a Special Open Door Forum (ODF) to allow DMEPOS suppliers, physician, treating practitioners and other interested parties to ask questions related to the Medicare Expanded Prior Authorization Demonstration for Power Mobility Devices (PMDs) Demonstration.

The purpose of this Special Open Door Forum (ODF) is to provide an opportunity for suppliers and providers to receive information and ask questions about the expanded demonstration.

On September 1, 2012 the CMS implemented a prior authorization process for PMDs (scooters and power wheelchairs) in seven states with high populations of fraud- and error-prone providers (CA, IL, MI, NY, NC, FL and TX). Initial data indicates that the Prior Authorization Demonstration was successful in reducing spending and improper payments for PMDs.   The CMS believes the recent decrease in overall spending is due in part to national Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers adjusting their billing practices and reflects suppliers complying with CMS policies based on their experiences with prior authorization in the demonstration states. Prior authorization is driving initial successes, ensuring that only beneficiaries who meet Medicare requirements receive a PMD. Suppliers have also increased compliance with CMS policies based on their experiences with prior authorization in the demonstration states.

The Durable Medical Equipment industry feedback has been positive thus far. Several suppliers have suggested prior authorization helps their business operations by providing a more predictable cash flow and reduced burden. These suppliers have expressed support for the demonstration and would like it to be expanded to other states and items. Feedback from beneficiaries has been largely positive.

Based on the demonstration’s initial success in reducing spending and improper payments, and the support received by various stakeholders, CMS seeks to expand the current demonstration to 12 additional states, for a total of 19 states, with all demonstration requirements remaining the same. Those states include: Pennsylvania, Ohio, Louisiana, Missouri, Maryland, New Jersey, Indiana, Kentucky, Georgia, Tennessee, Washington, and Arizona.

To read more about the Demonstration visit:

Participants may submit questions prior to the Special ODF to 
We look forward to your participation.

Special Open Door Participation Instructions:
Participant Dial-In Number: 1-800-603-1774
Conference ID #: 70084507

Note: TTY Communications Relay Services are available for the Hearing Impaired. For
TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.

A transcript and audio recording of this Special ODF will be posted to the Special Open
Door Forum website at and will be accessible for downloading.

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