# Medicare Program; Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies
> **Centers for Medicare and Medicaid Services** · Final rule. · Published 2015-12-30 · Effective 2016-02-29 · 80 FR 81674
## Document
- **Document number:** 2015-32506
- **Category:** medicare
- **Sub-agency:** Centers for Medicare and Medicaid Services
- **Federal Register citation:** 80 FR 81674
- **CFR reference:** 42 CFR 405
- **Publication date:** 2015-12-30
- **Effective date:** 2016-02-29
- **HHS docket:** CMS-6050-F
## Abstract

This final rule establishes a prior authorization program for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items that are frequently subject to unnecessary utilization. This rule defines unnecessary utilization and creates a new requirement that claims for certain DMEPOS items must have an associated provisional affirmed prior authorization decision as a condition of payment. This rule also adds the review contractor's decision regarding prior authorization of coverage of DMEPOS items to the list of actions that are not initial determinations and therefore not appealable.

## Source
- [Federal Register document](https://www.federalregister.gov/documents/2015/12/30/2015-32506/medicare-program-prior-authorization-process-for-certain-durable-medical-equipment-prosthetics)
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