UPDATE

 

CMS has canceled the January 11 Special Meeting and the January 12 Listening Session due to the delay in the beginning of Demonstrations.  

 

CAMPS will continue to provide you with information regarding rescheduling of these meetings as it becomes available. 

 

CMS Provides Details and Provider Meeting Information on Power Mobility Prior Authorization Pilot for California 

  

The Prepayment Review and Prior Authorization demonstration will implement prepayment review and prior authorization for PMD's in seven States (CA, FL, IL, MI, NY, NC & TX). In Phase 1 of the demonstration, 100 percent pre-payment review of PMD claims will be conducted. Then in Phase 2, a prior authorization approval will be require before a PMD claim can be submitted for full payment by Medicare. However, CMS will provide at least 30 days notice before the demonstrations begin.

 

 

Please click here for the full Memo regarding Demonstrations issued by CMS.

  

CANCELED - On January 11, 2012 CMS is conducting a Special Meeting on: The Medicare Prepayment Review and Prior Authorization Demonstration Project for Power Mobility Devices (PMDs). Please click here for a full description of the meeting. 

  

CANCELED - On January 12, 2012 CMS is conducting a Listening Session for Medicare Providers and Suppliers on: The Medicare Prepayment Review and Prior Authorization Demonstration Project for Power Mobility Devices (PMDs). Please click here for a full description of the event.

Click here to view the letter Noridian sent California DME suppliers with regard to the PMD demonstration project.

Update of Medi-Cal Provider Rate Reductions

CAMPS has joined a coalition to be named as a plaintiff in a complaint filed in federal court seeking an injunction to halt the 10% provider rate reduction. The amended complaint should be filed by end of this week and some individual CAMPS members will have declarations included as part of the evidence showing the likely impact of this reduction. A similar filing by the hospital association in the same federal court seeking to enjoin the 10% reduction for hospital inpatient services has resulted in a final ruling   issued yesterday from the Judge enjoining the hospital and distinct part SNF reductions. Our complaint will not be heard for 30 days after the filing meaning no hearing until end of January.

 

In the meantime DHCS has posted a notice on their website indicating their intent to implement to the 10% cut and recoupment sometime in the near future. It is possible that DHCS could begin the cuts and recoupment prior to the hearing, but with the injunction now issued on the other reductions it is a strong indicator that our action might also be successful. DHCS . Providers need to monitor the situation and we will certainly provide information as it becomes available.

 

If you haven't yet contributed to the CAMPS legal fund for this Medi-Cal litigation please go to the CAMPS website at www.campsone.org for contribution information. We need your financial support.

 
Click here for a Legal Fund Contribution Form.  

 

For more information, please call Bob Achermann at 916/443-2115 or email at [email protected].