Items Related to Prior Authorization

November 13, 2017

Letter to Rep. Blackburn (R-TN) regarding the DMEPOS Access and Transparency Act of 2017

The Coalition sent a November 2017 letter to Rep. Marsha Blackburn (R-TN) in reference to H.R. 2445, the DMEPOS Access and Transparency Act of 2017, also known as the DATA Act of 2017. The proposed legislation would amend title XVIII of the Social Security Act to provide for a prior authorization process under the Medicare program for certain high-cost DMEPOS. The Coalition letter supported the Act and requested an amendment be offered to exclude negative pressure wound therapy (NPWT) from any prior authorization process. "While we generally support the DATA Act and its provisions to protect suppliers of durable medical equipment, prosthetics, orthotics and supplies (“DMEPOS”) from burdensome and potentially duplicative pre- and post-payment audits when they participate in a prior authorization program, the approach would unintentionally undermine the treatment protocol and quality of care for those patients who require Negative Pressure Wound Therapy,” wrote the Coalition.
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