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  • Shared Systems Changes and Automation of Prior Authorization Requests
  • Post author
    Lacy Gaskins

Shared Systems Changes and Automation of Prior Authorization Requests

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) accommodate Shared System changes related to automation of prior authorization requests and other aspects of CMS systems integration.

Full Transmittal: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R1928OTN.pdf

Subject: Multi-Carrier System (MCS), Fiscal Intermediary Shared System (FISS) and VIPS Medicare Shared System (VMS) Automation of Prior Authorization (PA) Requests/Pre-Claim Reviews (PCR) and their Responses with Multiple Services (for programs like Home Health(HH)) via the Electronic Submission of Medical Documentation (esMD) System

Number: 1928

Title: 10087

Release Date: October 4, 2017

Effective Date: April 1, 2018

Implementation Date: January 2, 2018 

Special Notes: Transmittal 1904, dated August 18, 2017, is being rescinded and replaced by Transmittal 1928, dated October 4, 2017, to revise the flat file specification attachment and to remove STC from requirement 10087.9. All other information remains the same.

  • Post author
    Lacy Gaskins