CMS finalizes prior authorization rule for DME

In a move meant to prevent fraud while protecting access to medically necessary supplies, the CMS issued a final rule that mandates prior authorization for some durable medical equipment prosthetics, orthotics and supplies, known as DMEPOS.

The rule states that the documentation to meet authorization for DMEPOS is needed earlier in the process in order to furnish the items, which are often mobility devices like motorized wheelchairs.  Medicare will pay up to 80% of their cost if a physician deems the item is necessary; they can can cost $5,000 or more.

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