Kansas Administrative Regulations
Agency 129 - KANSAS DEPARTMENT OF HEALTH AND ENVIRONMENT-DIVISION OF HEALTH CARE FINANCE
Article 5 - PROVIDER PARTICIPATION, SCOPE OF SERVICES, AND REIMBURSEMENTS FOR THE MEDICAID (MEDICAL ASSISTANCE) PROGRAM
Section 129-5-108 - Scope of services for durable medical equipment, medical supplies, orthotics, and prosthetics
Universal Citation: KS Admin Regs 129-5-108
Current through Register Vol. 43, No. 12, March 20, 2024
(a) Selected durable medical equipment (DME) shall be available to each beneficiary, with the following limitations:
(1) The DME shall
be the most economical to meet the beneficiary's need.
(2) The least expensive and most appropriate
method of delivery shall be used. If round-trip delivery is over 100 miles,
prior authorization shall be required.
(3) Used equipment with a warranty specified
by the agency shall be used if available.
(4) Certain DME designated by the agency
shall be the property of the agency.
(5) Educational, environmental control, and
convenience items shall not be covered.
(6) DME shall be covered for only the
following types of beneficiaries:
(A)
Participants in the Kan Be Healthy program;
(B) beneficiaries who require the DME for
life support;
(C) beneficiaries
who require the DME for employment; and
(D) beneficiaries who would require more
expensive care if the DME was not provided.
(7) DME services provided for the parenteral
administration of total nutritional replacements and intravenous medication in
the beneficiary's home shall require the provision of services by a local home
health agency, physician, advanced registered nurse practitioner, physician
assistant, or pharmacist.
(b) Selected medical supplies shall be available to each beneficiary for use in the beneficiary's home.
(c) Selected DME and medical supplies shall be considered for coverage only in cases in which exceptional hardship or medical need has been justified by documentation of medical necessity or by the granting of prior authorization.
(d) Orthotics and prosthetics shall be available to program beneficiaries from orthotic and prosthetic dealers enrolled under K.A.R. 30-5-59.
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