CMS proposes prior authorization demonstration project for home health

The Centers for Medicare & Medicaid Services proposes to establish a demonstration project that would require prior authorization for Medicare fee-for-service coverage of home health services in Florida, Texas, Illinois, Michigan and Massachusetts, according to a recent CMS notice. The demonstration would apply to about 900,000 claims per year when fully implemented. CMS intends that the prior authorization process would be similar to those for power mobility devices, as well as TRICARE, certain state Medicaid programs, and private insurance models. CMS will accept comments through April 11 on its intent to collect information for the project, and plans to discuss the demonstration during an Open Door Forum in March.