Prior authorization has been an increasingly popular Medicare initiative for DMEPOS in the last few years. First with the live expansion of the PMD Prior Authorization demo into 12 new states and...
The bill requires the HHS Secretary to expedite emergency review of prior authorization requests to ensure same day delivery expectations can be met by suppliers for items such as Oxygen.
The regulation requires that stakeholder input be included in the development process and that priority be assigned to items that are subject to a high number of contractor audits (specifying Oxygen as a priority).
Overall the tone of the bill is positive and seeks to reduce the audit burden for suppliers providing high cost DME items through a prior authorization process. To see the full text of the bill use this link: http://thomas.loc.gov/cgi-bin/query/z?c114:H.R.2437:.