For items routinely denied by Medicare,

CMS: States Don’t Need Medicare Denials Before Medicaid Covers DME

January 09, 2019
CMS says in recently released guidance that states do not need to obtain a Medicare denial for certain durable medical equipment coverage before Medicaid, which acts as a secondary payer for those dually eligible for Medicare and Medicaid, can pay for the equipment. The agency suggests states consider creating a list of DME not covered by Medicare in order to expedite Medicaid coverage, and notes Medicare Administrative Contractors already post up-to-date lists of these items. Beneficiary advocates and DME lobbyists...

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