The Centers for Medicare & Medicaid Services (CMS) has announced major changes to its Medicare power mobility device (PMD) demonstration project.
CMS now says the project will move forward on or after June 1, 2012.
Other major changes that CMS announced:
— CMS will accept comments and recommendations from physicians and suppliers wishing to make suggestions on how to reduce the additional paperwork that the demonstration project will cause. Recommendations will be accepted during a 60-day comment period.
— The prepayment review, referred to as phase 1 in CMS’s original program descriptions, has been eliminated.
— The revamped demonstration project will require only prior authorization for PMD from the seven states chosen for the program (California, Florida, Illinois, Michigan, New York, North Carolina, Texas).
— Prior authorization requirements will start at approximately the same time in all seven states. CMS had previously said prior authorization would roll out, thus creating different start dates among the states.
The project had been scheduled to start Jan. 1 of this year, after being suddenly announced in mid November. A few days before the launch date, CMS announced a postponement, with no future start day indicated.
The demonstration project will impact most power mobility vehicles:
— Power-operated vehicles (aka, scooters): HCPCS codes K0800-K0805 and K0809-K0812.
— Standard power chairs: HCPCS codes K0813-K0829.
— Group 2 complex rehab power chairs: HCPCS codes K0835-K0843.
— Group 3 complex rehab power chairs without power options: HCPCS codes K0848-K0855.
— Pediatric and Group 4 power chairs: HCPCS codes K0887-K0891.
— Miscellaneous power wheelchairs with HCPCS code K0898.
Prior to the last-minute delay, industry and consumer advocates expressed concern that the project would put already stressed mobility providers under further financial pressure, and would reduce timely accessibility to power chairs and scooters for Medicare beneficiaries who needed them.
For more information and updates on the PMD demonstration project, go to https://www.cms.gov/CERT/02_Demonstrations.asp.
