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    Medicare to Require Prior Authorization for Hospital Outpatient Vein Ablation Procedures on July 1, 2020

    June 03, 2020

    As previously announced CMS’s Medicare Administrative Contractors (MACs) are going to require prior authorizations for all vein embolization procedures done in hospital outpatient departments starting July 1, 2020. They will accept requests for authorization starting June 17, 2020. They also targeted the following five other types of procedures: blepharoplasty, botulinum toxin injections, panniculectomy, and rhinoplasty. SCAI is reaching out to other concerned physician specialties to work together in opposing the implementation of this program. 

    CMS explained its plans on a conference call on May 28, 2020. They encountered a lot of feedback questioning the appropriateness of doing this as we are (hopefully) emerging from a Pandemic, but CMS staff seemed to be undeterred. CMS’s announcement of this call included slides. On page 24 of the slides are links to the MAC’s web sites that include more detailed local information.