APMA Urges CMS to Reconsider Prior Authorization Expansion

APMA called on CMS to reverse its decision to require prior authorization for HCPCS code L1932-an ankle-foot orthosis essential for treating conditions that impact mobility and function. APMA warns that this requirement could delay access to medically necessary care and negatively affect patient outcomes, particularly for those with ambulatory challenges. This requirement is set to take effect April 13.

APMA also emphasized the significant administrative burden prior authorization places on providers and urged CMS to use targeted, data-driven programs to address fraud and improper payments instead. APMA reaffirmed its commitment to working with CMS through provider education and collaboration to ensure compliance, while preserving timely patient access to care.

Contact the APMA Advocacy Department with any questions at [email protected].