In a recent news release, the American Association for Homecare articulated its disappointment in Medicare’s implementation of a prior authorization program for power wheelchairs that reportedly did not include a clinical template to assist physicians in documenting a patient’s medical need for mobility assistance. The release notes that the Centers for Medicare and Medicaid Services (CMS) announced that prior authorizations will begin September 21, 2012. The 3-year demonstration program requires that all power mobility claims in California, Florida, Illinois, Michigan, New York, North Carolina, and Texas be submitted for prior authorization.
Tyler Wilson, American Association for Homecare president and CEO, maintains that the prior authorization program could potentially receive more support from physicians, providers, and advocates for individuals with disabilities if it were combined with a clinical template. Wilson says the decision could prove to be a challenge for those seeking to age at home, who may face delays in receiving their power wheelchairs or may not be able to receive the power wheelchairs prescribed by their physicians.
The American Association for Homecare calls the addition of a clinical template crucial, as it could help standardize the collection of a patient’s medical information provided by physicians. The release reports that while CMS agrees that a template may hold promise and is developing one, it did not link it to the implementation of the prior authorization program. Wilson calls for the implementation of a system that incorporates this template and helps prevent both fraud and allows individuals to receive the mobility assistance necessary to remain safe and live independently in their homes.
Source: American Association for Homecare