CMS Extends Prior Authorization for 2018
CMS Announces Extension of Prior Authorization for Repetitive Non-Emergency Ground Ambulance Transports
On December 4, 2017, CMS posted a notice on its website indicating that it would be extending the prior authorization demonstration project for another year. The extension is limited to those areas where prior authorization was in effect for calendar year 2017. The affected states are Delaware, Maryland, New Jersey, North Carolina, Pennsylvania, South Carolina, Virginia, and West Virginia, as well as the District of Columbia. The extension will run through December 1, 2018.
In its notice, CMS indicated that claims with dates of service between December 2 and December 4, 2017 would not be subject to prior authorization or prepayment review, but that ambulance providers could elect to submit a request for prior authorization for these transports. All repetitive non-emergency transports on or after December 5, 2017 would require prior authorization.
2018, Centers for Medicare and Medicaid Services (CMS), Delaware, dialysis, New Jersey, Non-Emergency Mobile Healthcare (NET, NEMT, IFC), North Carolina, Pennsylvania, prior authorization, South Carolina, Washington D.C., West Virginia