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Medicare to expand 'prior authorization' for device coverage

The Hill, May 23, 2014

In a shift from the current system, Medicare is proposing to rule on seniors' coverage for home medical devices before the supplies are delivered or claims for payment are submitted. The Centers for Medicare and Medicaid Services (CMS) is planning to expand the use of "prior authorization" for power scooters and wheelchairs, and introduce the process for several other categories of medical goods used at home. Officials said the effort is targeting improper payments and fraud in the system, when Medicare foots the bill for products aggressively marketed to patients and doctors who do not need them.