CMS Explores PMD Physician Evaluation Template

Templates could become important element in CMS's pre-payment review demo project.

The Centers for Medicare and Medicaid Services is exploring the development of an electronic clinical template that would let electronic health record vendors create prompts to assist physicians when documenting the power mobility device face-to-face encounter for Medicare.  

A draft template from CMS is available at www.cms.gov/ESMD/08_ElectronicClinicalTemplate.asp#TopOfPage.

The American Association for Homecare reports that the association and its Complex Rehab and Mobility Council (CRMC) have been "ardent" supporters of a template to improve physician documentation for power mobility devices due to possible prepayment  review of PMD claims.

This issue came to a head when CMS announced last November that it would launch a prepayment review and prior authorization demonstration project for various power mobility devices in California, Florida, Illinois, Michigan, New York, North Carolina and Texas starting on Jan. 1 2012. The demonstration as initially designed did not contemplate the use of a physician template. When the demonstration was announced last year, the CRMC and other stakeholders immediately acted to stop the demonstration from going into effect. Addressing the project is of "paramount" importance, not only because of its impact on PMD providers and patients, but because CMS intends to apply prior authorization programs to other DME categories, as well, the association reports.

Since that time, AAHomecare has been working closely with CMS to develop a workable prior authorization program for PMDs. To date, the association says it has been successful in convincing CMS to eliminate the prepayment review portion of the demonstration and persuade CMS to allow the use of a clinical template approach to improving physician documentation of medical necessity.  AAHomecare says it also has been advocating for simplifying the coverage policy and create more clear educational material for both physicians and power mobility providers.
  
CMS has stated that it will host a series of open door forum calls to provide an opportunity for suppliers and physicians to provide feedback on the PMD electronic clinical template for Medicare purposes for possible nationwide use. The PMD Electronic Clinical Template calls are scheduled for April 10, June 14, July 10 and Sept. 25, from 2 p.m. to 3 p.m. Easter Time. Dial-in details have not yet been released.

About the Author

David Kopf is the Editor of HME Business.

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