CMS Call Outlines Demonstration Project Details

Today’s Open Door Forum yields PMD prior authorization project dates.

The Centers for Medicare and Medicaid Services is still aiming for a June 1, start date for the power mobility device demonstration project, but the date is still not firm, according to CMS representatives hosting today’s Open Door Forum call.

Also, CMS officials on the call, which was chaired by Barbara Cebuhar of CMS’s office of public engagement, said the turnaround time for prior authorizations being submitted the first time will be 10 business days, though there is a 48-hour expedited turnaround for emergency cases. The industry has been pushing for that turnaround to be reduced to seven days.

While CMS contends this should not be an additional burden on suppliers because they are not asking for any new or additional documentation, representatives on the call did admit they are significantly staffing up to compensate for the fact that all claims will be coming to them up front. And they seemed uncertain about whether a prior-authorization approval would prevent the same claim from being audited down the line by another entity.

Additional facts from the call:

• The project will run three years, and is hence currently scheduled to end in May 2015, assuming a June 2012 start date.
• CMS will hold monthly open door forums expressly about the demonstration project.
• The June start date is expected to be published in the Federal Register in May.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.

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