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HHS/CMS | RIN: 0938-AS68 | Publication ID: Fall 2016 |
Title: Prior Authorization of Certain Chiropractic Services for Certain Chiropractors (CMS-6070-IFC) | |
Abstract:
This interim final rule with comment period, in accordance with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), establishes a prior authorization process as a condition of Medicare payment for manual manipulation services provided on or after January 1, 2017 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. |
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Agency: Department of Health and Human Services(HHS) | Priority: Other Significant |
RIN Status: Previously published in the Unified Agenda | Agenda Stage of Rulemaking: Proposed Rule Stage |
Major: No | Unfunded Mandates: No |
CFR Citation: 42 CFR 405 42 CFR 410 42 CFR 414 | |
Legal Authority: Pub. L. 114-10, sec 514 |
Legal Deadline:
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Timetable:
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Regulatory Flexibility Analysis Required: Undetermined | Government Levels Affected: None |
Small Entities Affected: Businesses | Federalism: No |
Included in the Regulatory Plan: No | |
RIN Data Printed in the FR: No | |
Agency Contact: Melanie Combs-Dyer Director, Provider Compliance Group Department of Health and Human Services Centers for Medicare & Medicaid Services Center for Program Integrity, MS: AR-26-30, 7500 Security Boulevard, Baltimore, MD 21244 Phone:410 786-7683 Email: melanie.combs-dyer@cms.hhs.gov |