The Centers for Medicare and Medicaid Services (CMS) announced the Prior Authorization rule for Durable Medical Equipment (DME) on December 30, 2015. The rule becomes effective on February 29th, but CMS has not yet released the final "Required List" of DME items that will be officially subject to the first round of prior authorization. On February 11th, CMS posted an alert to the dedicated DME Prior Authorization webpage stating that although the file rule will be effective on February 29th, there is no current timeline established for implementation.
The next step requires CMS to release the initial list of DMEPOS items requiring prior authorization via Federal Register notice. Once the list is posted, suppliers will have 60 days to comply.
As with other recent regulatory changes (5010, ICD-10, Face-to-Face, etc.), preparation for this new process will be critical to a successful transition. There are 135 DMEPOS items on the Master List that could potentially be subject to prior authorization. When the time comes, having a strong process will ensure your organization is ready to tango. Join us on March 8th as Andrea Stark talks suppliers through which products are subject to this program, which HCPCS are likely to be included in the final list, how the rule will be rolled out and how to increase the likelihood of success under this new protocol. Register online here.
The next step requires CMS to release the initial list of DMEPOS items requiring prior authorization via Federal Register notice. Once the list is posted, suppliers will have 60 days to comply.
As with other recent regulatory changes (5010, ICD-10, Face-to-Face, etc.), preparation for this new process will be critical to a successful transition. There are 135 DMEPOS items on the Master List that could potentially be subject to prior authorization. When the time comes, having a strong process will ensure your organization is ready to tango. Join us on March 8th as Andrea Stark talks suppliers through which products are subject to this program, which HCPCS are likely to be included in the final list, how the rule will be rolled out and how to increase the likelihood of success under this new protocol. Register online here.
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