Last week, while it seemed that the entire country was on vacation, Medicare took advantage of the disconnection to release a final rule which will impact every lower limb prosthetic patient in their system. Leave it to the Federal government to try to slip changes in policy past the watchful public by taking advantage of holiday vacation habits! According to the newly adopted policy, lower limb prosthetic components over $1,000 will now require pre-authorization.
Unlike most private insurers, Medicare has been operating under a build, bill and pay system. The Prosthetist built the device and submitted payment at the time of delivery. Pre-authorization for the device (and individual components) was not required. The new Medicare rule will change this system.
Yesterday Dave and I recorded a podcast to discuss this issue. Rest assured, when the rest of the world is on vacation, we remain connected to any possible changes concerning access to prosthetics.
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