Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1737 - SCOPE AND CONTENTS OF THE FEE FOR SERVICE MEDICAL ASSISTANCE PROGRAM
Subchapter 7 - ANCILLARY MEDICAL SERVICES
Section 17-1737-73 - Medical supplies
Current through February, 2024
(a) Medical supplies means medical items prescribed by a licensed physician that are medically necessary for the treatment, care, or observation of a medical condition.
(b) Medical supplies include, but are not limited to, insulin syringes and needles, ostomy appliances and supplies, urine test materials, contraceptive devices, incontinence pads or devices, catheters, urine bags and tubing, ice bags, and hot water bottles or heating pads.
(c) Medical Authorization shall be required when the line item billed cost of the items prescribed exceeds $50 per month, except for intra-uterine devices for family planning purposes for which the cost may exceed $50 per month.
(d) The following items shall not be covered by the program:
(e) Medical supplies billed using a miscellaneous Health Care Financing Procedure Coding System (HCPCS) code are required to have a copy of the invoice submitted for the equipment billed. Payment for medical supplies will be based on the invoice amount plus a negotiated percentage amount.
(f) Medicare's criteria is followed for the coverage of medical supplies unless specifically stated elsewhere. This provision also applies to the maintenance, replacement, and repair of medical supplies.