WASHINGTON, D.C. (December 29, 2015)—CMS finalized the rule to implement Prior Authorization for general DMEPOS items. The final rule was published on December 29th. The proposed rule, published in May 2014, suggested that a prior authorization requirement be imposed for selected HCPCS that are frequently subject to unnecessary utilization. The originally proposed master list consisted of 139 HCPCS.

WASHINGTON, D.C. (December 23, 2015)—Provisions from H.R. 284, legislation that passed the House in March 2015 were ultimately folded into H.R. 2, comprehensive Medicare legislation popularly known as the “Doc Fix,” which was ultimately signed into law on April 16, 2015. The legislation improves the competitive bidding in these three concrete ways:

WASHINGTON, D.C. (December 23, 2015)—The initial HME Audit Key test survey from earlier this year tracked audits received from October 2014 through June 2015. One of the preliminary findings was suppliers appealed 80 percent of MAC prepayment denials for respiratory products, and 92 percent were overturned. While based on a small test pool of participants, other findings from the survey indicate that:

WASHINGTON, D.C. (December 18, 2015)—Under a rare procedure to get a bill quickly considered by Congress, the The Patient Access and Medicare Protection Act (S. 2425) was passed by both the Senate and House today.