Medicare Shift To Front-End Payment Reviews Causes Anxiety, But Actual Impact May Be Small
This article was originally published in The Gray Sheet
The jury is still out on whether new Medicare pre-payment review efforts will meaningfully reduce procedure volumes and device consumption, but hospital execs and others say that such an outcome is unlikely.
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Demos to test the use of prior authorization and pre-payment review for power mobility equipment and pre-payment review for selected hospital inpatient services were slated to begin Jan. 1. Both have been delayed “until further notice.”
The Medicare agency plans to launch a demonstration project next year on prepayment review and prior authorization of power mobility devices, but it faces resistance from industry trade group AAHomecare.
FDA action awaits Sun’s manufacturing facility in Halol after it failed to adequately address GMP deviations, though India’s top-ranked drug firm appears to have effectively lowered its dependence on the site that has had a patchy compliance run.