WASHINGTON, D.C. (May 31, 2019)—The Centers for Medicare & Medicaid Services (CMS) will be hosting two Special Open Door Forums (ODF) on June 4 and June 12, 2019.

Prior Authorization

On June 4, CMS will host an ODF from 2:00 pm to 3:30 pm EDT on the implementation of prior authorization (PA) for pressure reducing support surfaces. This ODF is a follow-up from an announcement published in the Federal Register on April 22.

Five support surfaces codes were added to the PA program:

  • E0193: Powered air flotation bed (low air loss therapy)
  • E0277: Powered pressure reducing air mattress
  • E0371: Nonpowered advance pressure reducing overlay for mattress length and width
  • E0372: Powered air overlay for mattress, standard mattress length and width
  • E0373: Nonpowered advanced pressure reducing mattress

Prior authorization will be implemented in two phases: California, Indiana, New Jersey and North Carolina will require PA for the codes beginning July 21. The program will be implemented nationally Oct. 21.

The ODF will cover:

  • the process of submitting a PA request;
  • timeframes for the MACs to make a decision on a PA request; and
  • subsequent claim submission process.

Find additional information here.

Instructions for participation
Participant Dial-In Number: 5960428
Conference ID #: (800) 837-1935

Hospice Assessment Tool

On June 12, the Center for Clinical Standard and Quality (CCSQ) will host an ODF to hallow hospices and others to ask questions on the development of the a Hospice Assessment Tool. The ODF will be from 2:00 pm to 3:00 pm EDT.

The hospice assessment tool would enable CMS and hospices to understand care needs of people through the dying process and ensure the safety and comfort of individuals enrolled in hospice institutions nationwide. The ODF will provide a status update on the development of the tool.

Learn more about the tool here.

Instructions for participation
Participant Dial-In Number: (800) 837-1935
Conference ID #: 9490006