Tag: PMD demo
PA program spreads out
August 24, 2018Liz Beaulieu, Editor
WASHINGTON - Industry stakeholders expect it to be mostly business as usual on Sept. 1, when CMS is set to expand a demonstration project requiring prior authorizations for standard power mobility devices nationwide.
Prior authorizations for these devices were previously required in 19 states.
“We remain optimistic because the demonstration has been mostly successful so far,” said consultant Sylvia Toscano, owner of Professional Medical Administrators.
Already part of the National...
CMS issues guidance on national PA program
August 9, 2018HME News Staff
WASHINGTON - CMS has published guidance for power mobility device providers on the transition to the national prior authorization program. “Inclusion of Power Mobility Device Codes in the Prior Authorization Program for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Items” lists all the HCPCS codes that will be included in the program starting Sept. 1, according to a bulletin from AAHomecare. For states not currently in the demonstration, the MACs will start accepting...
CMS shifts mobility codes into nat'l prior authorization program
June 8, 2018Liz Beaulieu, Editor
WASHINGTON - CMS says a demonstration project requiring prior authorization requests for power mobility devices in 19 states will become permanent and will expand to all states.
CMS announced June 1 that it will transition nearly all of the codes included in the demo project, which was set to expire on Aug. 31, to its national prior authorization program on Sept. 1. Currently, the agency has two codes in the national program: K0856 and K0861, two complex rehab codes.
“This is something...
CMS expands prior authorization program
June 4, 2018HME News Staff
WASHINGTON - CMS will roll the standard power mobility device codes that are currently part of a PMD Prior Authorization Demonstration in 19 states into the National Prior Authorization Program on Sept. 1, the agency announced late on Friday.The PMD PA Demo was due to expire Aug. 31. Industry stakeholders have been lobbying CMS to expand the prior authorization requirement for PMDs to all states and to also apply it to complex rehab wheelchairs.Currently, there are only two codes in the National...
CMS evaluating PMD demo
January 27, 2017HME News Staff
WASHINGTON - CMS has contracted with Provider Resources to conduct an evaluation of its power mobility device demonstration project. CMS has sent letters to physicians, asking them to schedule interviews with Provider Resources to share their opinions and thoughts on the process. “Your feedback could have a direct impact on how PMDs and other services or supplies could be requested and/or processed in the future,” the agency states in its letter to physicians. As part of the demo, which...
PMD demo extended, but not expanded
July 17, 2015Tracy Orzel
WASHINGTON - Industry stakeholders say CMS's decision to extend the PMD demo through August 2018 is a step in the right direction, but more needs to be done.“We're looking to expand the demo to all 50 states and to include Group 3 complex rehab items, as well as options and accessories provided on all power mobility devices,” said Seth Johnson, vice president of government affairs for Pride Mobility Products.CMS on Wednesday announced its decision to extend the PMD demo, which was set...
CMS extends PMD demo
July 14, 2015HME News Staff
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.The demo, which requires prior authorizations for certain PMDs, was set to expire Aug. 31.“This is a smart program, and an example of what can happen when HME providers and CMS work together,” said Tom Ryan, president and CEO of AAHomecare in a press release.The demo kicked off in seven states in September...
Cures Act has wins, losses for HME industry
July 10, 2015Theresa Flaherty, Managing Editor
WASHINGTON - A bright spot in the high-profile 21st Century Cures Act that the House of Representatives passed on Friday: a provision that would extend CMS's PMD demo.The provision would extend the demo, which requires prior authorizations for certain PMDs, through at least Aug. 31, 2018.“It's a really big step forward in terms of expanding the demo nationwide,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “This was language that the industry...
New language gives stakeholders new hope
July 9, 2015HME News Staff
WASHINGTON - Lawmakers have added new language to the 21st Century Cures Act to extend CMS's power wheelchair prior authorization demonstration project, much to the relief of stakeholders.The latest version of the bill would extend the demo through at least Aug. 31, 2018, and expand it to include more states and more products.“AAHomecare is pleased that Congress supports extending and expanding this successful program," said Jay Witter, senior vice president of public policy, in statement....
Reporter's notebook: Is there a dark side to the PMD demo?
June 19, 2015Tracy Orzel
In a letter to the editor published in the May issue of HME News, Scooter Store founder Doug Harrison questioned the success of Medicare's PMD demo, pointing to a 69% decrease in utilization.“Please watch out for prior authorizations coming to any other product categories,” wrote Harrison. “You might be lucky to have 31% of your claims survive. Is that enough for your business to survive?”Which raised the question: Is the PMD demo hurting more than it's helping?The short answer...