Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE
Part XXI - Home and Community-Based Services Waivers
Subpart 11 - New Opportunities Waiver
Chapter 139 - Covered Services
Section XXI-13921 - Specialized Medical Equipment and Supplies
Current through Register Vol. 50, No. 9, September 20, 2024
A. Specialized medical equipment and supplies (SMES) are devices, controls, or appliances which enable the participant to:
B. The service includes medically necessary durable and nondurable medical equipment not covered under the Medicaid state plan. NOW does not cover non-medically necessary items. All items shall meet applicable standards of manufacture, design and installation. Routine maintenance or repair of specialized medical equipment is funded under this service.
C. All alternate funding sources that are available to the beneficiary shall be pursued before a request for the purchase or lease of specialized equipment and supplies will be considered.
D. Exclusion. Excluded are specialized equipment and supplies that are of general utility or maintenance, but are not of direct medical or remedial benefit to the beneficiary. Excluded also are those durable and non-durable items that are available under the Medicaid State Plan.
E. Service Limitations. There is a cap of $1,000 per three year period for a beneficiary for specialized equipment and supplies. On a case-by-case basis, with supporting documentation and based on need, a beneficiary may be able to exceed this cap with the prior approval of OCDD central office.
F. Provider Qualifications. All agencies who are vendors of technological equipment and supplies must be enrolled in the Medicaid Program as a durable medical equipment provider and must meet all applicable vendor standards and requirements for manufacturing, design and installation of technological equipment and supplies.
AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.
