0938-AS68 201804 Unified Agenda of Federal Regulatory and Deregulatory Actions 0938 Centers for Medicare & Medicaid Services CMS 0900 Department of Health and Human Services HHS Prior Authorization Process as a Condition of Medicare Payment for Services Provided by Certain Chiropractors (CMS-6070-P)

Under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), this proposed rule would establish a prior authorization process as a condition of Medicare payment for manual manipulation services provided by certain chiropractors whose pattern of billing is aberrant compared to their peers and whose services denial percentage is in the 85th percentile or greater, taking into consideration the extent that service denials are overturned on appeal. 

]]> Other Significant Previously Published in The Unified Agenda Proposed Rule Stage No No Other 42 CFR 405 42 CFR 410 42 CFR 414 Pub. L. 114-10, sec. 514 Statutory Final 01/01/2017 MACRA section 514 No NPRM 12/00/2018 No Businesses None No No No Melanie Combs-Dyer Director, Provider Compliance Group 0938 Centers for Medicare & Medicaid Services CMS 410 786-7683 melanie.combs-dyer@cms.hhs.gov Center for Program Integrity, MS: AR-26-30, 7500 Security Boulevard, Baltimore MD 21244