WASHINGTON, D.C. (January 7, 2016)—On December 29, 2015, CMS published the final rule to Medicare Program: Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies. This comes a year and a half after the proposed rule, which came out on May 28, 2014. Originally CMS proposed that the timeframe for a response to a prior authorization request would be made within 10 days or two days for expedited requests.


In addition to changing rates in non-bid locations, CMS plans to lower certain rates based on regional calculations, all under the guise of streamlining the bid program