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PA Demo for PMD extended through August 2018

Date Published: July 15 2015

Announced July 15, 2015, the Prior Authorization of Power Mobility Devices (PMDs) Demonstration has been extended for three years. The demonstration will now end on August 31, 2018 for all 19 states. The original demonstration requirements remain the same for all states.

The PA Demo began for orders written on or after September 1, 2012, in seven states (CA, IL, MI, NY, NC, FL and TX) and was originally scheduled to end on August 31, 2015. Due to a recent extension announced today by the Centers for Medicare and Medicaid Services, the demonstration is now scheduled to end on August 31, 2018.

According to CMS, the PA Demo is designed to develop and demonstrate improved methods for the investigation and prosecution of fraud in the provision of care or services under the health programs established by the Social Security Act. This demonstration will also lead to reductions in improper payments.

The CMS implemented a PA process for scooters and power wheelchairs for people with Fee-For-Service Medicare who reside in seven states with high populations of fraud- and error-prone providers. According to CMS, in addition to the benefits mentioned above, this demonstration will help ensure that a beneficiary's medical condition warrants their medical equipment under existing coverage guidelines. Moreover, the program will assist in preserving a Medicare beneficiary's ability to receive quality products from accredited suppliers.

Based on early successes, CMS expanded the demonstration to 12 additional states (MD, NJ, PA, IN, KY, OH, GA, TN, LA, MO, WA, and AZ) in July 2014.

DMEevalumate.com continues to help DME providers and referring practioners, who subscribe to the online electronic template, achieve a 99 percent PA approval rate for PMDs. As noted by provider Woody O’Neal: If it’s not documented, it’s not delivered! O’Neal recently passed a Medicare audit of PMD claims and attributes success to using DMEevalumate.com’s online documentation collection tool.   

For more information call 800-986-9368 or send an email to info@dmeevalumate.com.

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