APA WF 22-31 Elimination of the Certificate of Medical Necessity (CMN) Form Requirement for Most Medical Supplies, Equipment, and Appliances
The proposed revisions update rules regarding the prior authorization (PA) of most medical supplies, equipment, and appliances, by eliminating the requirement to include a Certificate of Medical Necessity (CMN) form when requesting the PA. The exception will be enteral and parenteral nutrition which will still require a CMN. All the other required documentation which is listed in the PA guidelines for that item will still be required to be submitted by the provider.
Please view the circulation document here: APA WF # 22-31 and submit feedback via the comment box below.
Circulation Date: 02/01/2023
MAC Meeting: 03/02/2023
Comment Due Date: 03/03/2023
Public Hearing: 03/07/2023
Board Meeting: 03/22/2023
Comments
Kelli Wallace-Stevens:
CMS has already eliminated the specific CMN forms for Medicare home medical equipment. These forms are redundant and unnecessary paperwork for the providers to complete, and supplies to track, as all the information on them must be present in the clinical evaluation anyway. Let's please stop requiring these forms!
OHCA Response:
Thank you for your comment. The Oklahoma Health Care Authority is following CMS in eliminating the CMN necessity.
Alicia Curtis:
These are redundant and unnecessary work for the supplier and doctor because all that information has to be in the medical assessment anyway.
OHCA Response:
Thank you for your comment. The Oklahoma Health Care Authority is following CMS in eliminating the CMN necessity.
Mary Wattles:
The CMNs are unnecessary and extra work for the doctors and the suppliers. All the information is in the documentation that must be obtained and its an extra step that takes extra time.
OHCA Response:
Thank you for your comment. The Oklahoma Health Care Authority is following CMS in eliminating the CMN necessity.
Lesa Baldwin:
These are redundant and unnecessary work for us the supplier and doctor since all the information is in the medical assessment.
OHCA Response:
Thank you for your comment. The Oklahoma Health Care Authority is following CMS in eliminating the CMN necessity.
Marsha Bruce:
These forms are redundant and unnecessary work for both the supplier and physician because the information has to be in the medical record.
OHCA Response:
Thank you for your comment. The Oklahoma Health Care Authority is following CMS in eliminating the CMN necessity.
Jessica Smith:
These are redundant and unnecessary work for the supplier and doctor because all that information has to be in the medical assessment anyway.
OHCA Response:
Thank you for your comment. The Oklahoma Health Care Authority is following CMS in eliminating the CMN necessity.
Judith Hornsey:
The doctors are very reluctant to sign the CMN as they have already sent a script or order for the product and have address the need for the equipment in the patient's chart notes. With the 30 day rule in place for DME this puts us in a place of losing the set up claim due the doctor not signing in a timely manner.
OHCA Response:
Thank you for your comment. The Oklahoma Health Care Authority is following CMS in eliminating the CMN necessity.
Tina Mills:
Eliminating CMN's is a wonderful idea because it's double the work for doctors and providers- when all the info. is in the Medical assessment.
Lori Adams:
Would truly like to stop needing to get CMN's signed for our Pt Bed's and Oxygen etc. Medicare has made it so that no CMN's are needed anymore. Less work, less tracking, or trying to find the Hospitalist that signed an order and now not in our area. Medicaid CMN's have been nightmare's and also because you only give us 30 days to get completed, or first month written off and on and on. Would be so thankful if you stop the need for CMN's for DME's equipment.
OHCA Response:
Thank you for your comment. The Oklahoma Health Care Authority is following CMS in eliminating the CMN necessity.
