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Medicare Program - Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library

Medicare Program - Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicare Program - Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule establishes a prior authorization program for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items that are frequently subject to unnecessary utilization. This rule defines unnecessary utilization and creates a new requirement that claims for certain DMEPOS items must have an associated provisional affirmed prior authorization decision as a condition of payment. This rule also adds the review contractor's decision regarding prior authorization of coverage of DMEPOS items to the list of actions that are not initial determinations and therefore not appealable. This book contains: - The complete text of the Medicare Program - Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section