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HHS/CMS | RIN: 0938-AS68 | Publication ID: Spring 2018 |
Title: Prior Authorization Process as a Condition of Medicare Payment for Services Provided by Certain Chiropractors (CMS-6070-P) | |
Abstract:
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. |
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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 |
EO 13771 Designation: Other | |
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: No | 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 |