Effective February 20, 2016, CMS has created a prior authorization process for certain identified DMEPOS before they can be approved for Medicare payment. Items subject to prior authorization will be identified on a Master List. According to CMS, there will be no new documentation requirements, but prior authorization will help ensure that applicable coverage, payment, … Read more

Overview The current Medicare physician payment formula, known as the "Sustainable Growth Rate" (SGR), was designed to control the growth in aggregate Medicare expenditures for physicians' services.[1]    If implemented as intended under the law, the SGR would lead to significant cuts to physician payment (for example, if the SGR were to go into effect in … Read more