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New rules affect medical equipment suppliers, patients

According to the Centers for Medicare & Medicaid Services, a final rule became effective Feb. 29 requiring pre-authorization on 135 items of medical equipment, prosthetics, orthotics and supplies that are frequently subject to unnecessary utilization.

But wait, on Feb. 11, the organization posted notice on it's website at CMS.gov that while the final rule is effective Feb. 29, the regulation does not include implementation dates for prior authorization of items. Advance notice through a Federal Register notice will occur at least 60 days prior to an implementation of prior authorization for any specific item.

This prior authorization process was meant to help ensure that certain items are provided consistent with Medicare coverage, coding and payment rules.

Medicare's medical equipment list evolving

CMS published a list of 135 items that could be included, but also stated all these items may not make the final cut on whether pre-authorization from Medicare will be required in the future.

This list of items is available on their website and includes items such as: power chairs, some oxygen equipment and c-pap equipment, and some prosthetic equipment.

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