—Via AAHomecare WASHINGTON, D.C. (August 10, 2016)—Last week, CMS announced that medical necessity no longer has to be met for replacement of essential accessories for a beneficiary-owned CPAP device or RAD. CMS and CMS contractors will now assume that beneficiary-owned CPAP devices and RADs have met their medical necessity requirements through the 13-month continuous usage. This policy only applies to replacement of accessories, and this policy does not apply to devices that have been used for less than 13 continuous months or devices that were not purchased through Medicare.
AAHomecare has been asking CMS for this policy change since 2014 and we are pleased to see this published. We have asked for further clarification on the exact documentation requirements for replacement supplies and will update our membership when we receive new information. The published policy change can be found here.
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