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Where is CMS Going on Prior Authorization?

February 18, 2016 at 2:32 pm

AOPA has presented free webinars for members on Prior Authorization on two dates – February 18 and February 25.  AOPA is committing substantial resources to additional education related to Medicare Prior Authorization.  Details of these resources are listed below: 1.       Introductory Webinar: February 18th and 25th 2016-2 separate dates (Available as a recording) 2.       February 2016 […]

Update on DME MAC Contractor Transition

January 28, 2016 at 4:16 pm

Following up on a previous Smart Brief announcement, regarding upcoming changes in the contractors who will serve as the Durable Medical Equipment Medicare Administrative Contractors (DME MACs), AOPA has learned about additional details regarding the transition of DME MAC Jurisdiction A and Jurisdiction B responsibilities. The denial of the NGS protest of the Jurisdiction B […]

CGS to be the New DME MAC for Jurisdiction B

January 21, 2016 at 12:37 pm

As AOPA reported earlier, CGS, the current Jurisdiction C DME MAC contractor, was awarded the Jurisdiction B contract on September 3, 2015. However, National Government Services (NGS), the current Jurisdiction B DME MAC, filed a formal protest causing CMS to halt the transition pending a review of the contract award by the Government Accountability office […]

Jurisdiction A DME MAC Contract Awarded to Noridian Health Solutions, LLC

January 5, 2016 at 1:49 pm

On December 16, 2015, the Centers for Medicare and Medicaid Service (CMS) announced that Noridian HealthCare Solutions, LLC. was awarded a contract to serve as the Jurisdiction A Durable Medical Equipment Medicare Administrative Contractor (DME MAC).  Noridian currently holds contracts to serve as the Jurisdiction D DME MAC as well as the Pricing, Data Analysis, […]

CMS Issues Final Rule on Medicare Prior Authorization for Certain DMEPOS Including Most Lower Limb Prostheses

December 30, 2015 at 2:32 pm

On December 29th, the Centers for Medicare and Medicaid Services (CMS) released the long anticipated final rule regarding Medicare prior authorization of certain DMEPOS, including most lower limb prostheses.  The final rule, which will be published in the December 30, 2015 Federal Register, will be implemented 60 days after it publication. AOPA has reviewed the […]

Congress Close to a Deal on Funding of the Federal Government; Modest Potential Impact on O&P and Suspension of Medical Device Excise Tax for Non-O&P in Play

December 17, 2015 at 12:28 pm

On Wednesday, December 16th, President Obama signed a short term spending measure that will allow the Federal government to continue to operate until December 22, allowing Congress to finalize its long anticipated Omnibus appropriations and tax break extender legislation that will fund the Federal government for the remainder of the 2016 fiscal year.  Two important […]

PDAC Announces Coding Verification Review for Ankle Gauntlets

December 9, 2015 at 9:05 am

The Pricing, Data Analysis and Coding contractor (PDAC) has announced that due to a change in the 2016 descriptor verbiage for L1902 and L1904, it will initiate a new coding verification for any ankle gauntlet style devices that contain joints that are currently listed on the PDAC site under L2999. Read the announcement. It is […]

2016 Medicare DMEPOS Fee Schedule Released

November 30, 2015 at 10:08 am

On November 23, 2015, the Centers for Medicare and Medicaid Services (CMS) released the 2016 Medicare DMEPOS fee schedule. As expected, Medicare fees for orthotic and prosthetic devices will be slightly lower in 2016 than they were in 2015. The annual update to the Medicare O&P fee schedule is based on a combination of the […]