WASHINGTON, DC – Meticulous preparation by complex rehab advocates will likely pay off next week when Sen Chuck Schumer (D-NY) is expected to introduce a Senate companion bill to H.R. 942, the Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013.
“This is a major victory for complex rehab users and providers,” say AAHomecare officials. “Schumer is the senior Senator from New York, and a member of the Senate Finance Committee—the committee with jurisdiction over Medicare. The Senate companion bill is expected to be introduced within the next two weeks, and AAHomecare will provide the bill number once one is assigned to the new legislation.”
Meanwhile, prior authorization and documentation requirements for power mobility repairs were back on the agenda last week with AAHomecare advocates asking senior CMS officials to address a problem faced by providers who repair PMDs for beneficiaries whose original provider is unable to do the repair.
The goal is to relieve the repairing provider from having to obtain medical necessity documentation from the original provider. Instead, advocates contend that new providers should have to show only that the repair is medically necessary. In addition to the PMD repair issue, prior authorization demonstration project communication problems between the DME MACs and PMD providers were discussed. Some PMD providers are receiving letters that are postmarked after the required 10-day response timeframe.
In many of these cases, the letter itself is dated within 10 days, but the postmark on the envelope indicates that it wasn’t sent until day 13, or even as late as day 17. This lag indicates that letters are sitting on someone’s desk or in the mailroom at CMS for days before they are mailed to providers.