Moving the HME Industry Forward

Legislative/Advocacy

AAHomecare in Action – Association Paves Way for Prior Authorization Language

July 13, 2015

WASHINGTON, DC – The newest version of the 21st Century Cures bill now includes language to extend the CMS power wheelchair prior authorization demonstration. With the current demonstration ending this August, the new provisions would extend the demo through at least Aug. 31, 2018, and add more states, power mobility devices, and accessories.

“AAHomecare is pleased that Congress supports extending and expanding this successful program,” said Jay Witter (pictured), senior vice president of Public Policy at AAHomecare. “Prior authorization, when implemented correctly, will be good for homecare patients, providers, and the American taxpayer.”

Back in June, as AAHomecare worked with the House Energy and Commerce Committee to delay the start date for a provision reducing Medicaid payments to 2020 instead of 2016, AAHomecare also planted the seed for inclusion of prior authorization language in the Cures Bill.

The potential linkage of Medicaid payments to competitive bidding rates is a serious issue, and pressing these back to 2020 is a significant delay, AAHomecare will continue to defend against the inclusion of these cuts in any future iterations of the Cures bill.

“Extension of the PMD prior authorization demo is a win-win all around,” says Mark Schmeler, PhD, OTR/L, ATP, assistant professor, School of Health and Rehabilitation Sciences, University of Pittsburgh. “It cuts down on waste, fraud, and abuse, and saves dollars over time, despite costing some money to administer. It ensures that people who really need devices get them, while recognizing and respecting the role of qualified providers and clinicians who are trained to assess and determine who needs powered mobility. It ultimately adds credibility to the rehab field of legitimate providers.”

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