Compliance: Prior Authorization Final Rule Will Transform DMEPOS Reimbursement

Article Overview

This compliance article covers a CMS final rule that changes how certain durable medical equipment, prosthetics, orthotics, and supplies are reviewed before Medicare payment. It explains the purpose of the prior authorization program, how the master and required lists are handled, the general review timelines, and the potential operational effects for suppliers, prosthetic and orthotic stakeholders, and other Medicare-focused providers. The article is relevant to billing, compliance, and reimbursement staff tracking Medicare policy changes affecting DMEPOS processes.