Friday, February 3, 2012

CMS Will Abandon Pre-Pay Phase of Power Mobility Demonstration

In response to comments from AAHomecare and other stakeholders, the Centers for Medicare and Medicaid Services (CMS) today announced two key changes to the prior authorization demonstration for power mobility devices (PMD). The key modifications are:
  • CMS has removed the prepayment review phase (phase 1) of the demonstration and will go straight to the prior authorization phase.
  • The PMD provider will be allowed to submit the prior authorization request to CMS on behalf of the physician.
CMS expects the PMD prior authorization demonstration to begin on or after June 1, 2012, in the seven states impacted in the demonstration (California, Florida, Illinois, Michigan, New York, North Carolina, and Texas).

Tyler Wilson, AAHomecare president, stated, “We appreciate that after our numerous conversations with CMS, the Agency has responded to many of the concerns expressed by the HME sector. We look forward to working with CMS to ensure that the prior authorization demonstration is implemented in a way that is effective without negatively affecting beneficiaries and HME providers.”

CMS PMD demo page

Summary of the modifications

Text from the announcement follows, excerpted:
Prior Authorization of Power Mobility Devices (PMD) Demonstration

CMS received many comments/suggestions on the Prior Authorization of Power Mobility Devices (PMDs) demonstration. The CMS has considered these comments carefully.

In response to comments received from stakeholders, the CMS has made a number of modifications to the Prior Authorization of PMD demonstrations.
  • The CMS has completed a separate Paperwork Reduction Act (PRA) notification for this demonstration and the Recovery Audit Prepayment Review demonstration.
  • The CMS has removed the 100% Pre-Payment review phase (formerly Phase 1). All modifications that had previously been made to Phase 1, are no longer necessary or applicable as a result of the removal this phase.
  • The CMS will allow suppliers to perform the administrative function of submitting the prior authorization request on behalf of the physician/ treating practitioner.
  • This demonstration will begin only after an OMB PRA control number is obtained. The CMS anticipates the start of this demonstration will be on or after June 1, 2012.
To submit questions regarding the demonstration contact:

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