Are you exactly the same person today — physically, cognitively, task wise — as you were five years ago? That’s the basic and critical question behind the Clinician Task Force’s (CTF) recent letter to the Centers for Medicare & Medicaid Services (CMS) concerning CMS’s recent change to the Medicare five-year replacement rule for prior authorization…
Medicare Changes to 5-Year PMD Prior Authorization Rule: Inside the Clinician Task Force Response to CMS
2026 Proposed Rule: CMS Recommends Annual DMEPOS Accreditation, Prior Authorization Changes
The changes were listed in the proposed rule for the calendar year 2026 home health prospective payment system.
The Centers for Medicare & Medicaid Services (CMS) wants Medicare durable medical equipment (DME) providers to be re-accredited annually, and also wants to change the prior authorization process for suppliers billing Medicare. The proposed changes were listed in the Calendar Year 2026 Home Health Prospective Payment System Proposed Rule Fact Sheet, CMS-1828-P, released June 30.…
Carelon Takeover of Medicaid Authorization for Maryland, Missouri, Wisconsin Now on Hold
Carelon was due to start handling prior authorization requests on July 1.
The July 1 transition that would have transferred prior authorization requests to Carelon Medical Benefits Management for Medicaid programs in Maryland, Missouri, and Wisconsin has been put on hold. In a June 28 bulletin, the American Association for Homecare (AAHomecare) said the transition “has been postponed until further notice. Suppliers in Maryland, Missouri, and Wisconsin…