Prior Authorization


Prior Authorization:  O&P Was A Serious Player

Although CMS may have thrown us a curve when they published their proposal to require 89 lower limb prosthetic codes be subject to prior authorization on May 28, 2014, it became clear that in its proposed form, the rule would do more harm than good.

AOPA’s Board authorized an educational campaign to inform members about how this rule could impact patients in delaying access to care and delayed provider reimbursements among other problems.  AOPA held 2 free webinars for members to learn from AOPA Board members and staff about what Prior Authorization is and is not. AOPA submitted comments to CMS on behalf of members, and encouraged members to submit their individual comments or use the template and pre-written comments detailing the problems in the Prior Authorization proposal and what needed to be changed to make it workable for patients and the O&P community.   448 members commented using AOPA’s online portal on AOPAvotes.org.

AOPA also mailed all patient care member locations 10 postcards for distribution to amputee patients so they could register their concerns directly with CMS about how Prior Authorization will negatively impact patient care.  294 patient postcards were delivered to CMS by the July 28, 2014 deadline!

In total AOPA members and their patients submitted 742 comments, in addition to customized comments that members submitted directly to CMS.

Read AOPA’s statement here.

AOPA will keep you informed on any further developments from CMS.