Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

Prior Auth

CMS Final Rule for Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)

Effective February 20, 2016, CMS has created a prior authorization process for certain identified DMEPOS before they can be approved for Medicare payment. Items subject to prior authorization will be identified on a Master List. According to CMS, … [Read more...] about CMS Final Rule for Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)

Replacing the Broken Medicare Physician Payment Formula: At What Cost for People with Medicare?

Overview The current Medicare physician payment formula, known as the "Sustainable Growth Rate" (SGR), was designed to control the growth in aggregate Medicare expenditures for physicians' services.[1]    If … [Read more...] about Replacing the Broken Medicare Physician Payment Formula: At What Cost for People with Medicare?

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