Ohio Administrative Code
Title 5160 - Ohio Department of Medicaid
Chapter 5160-10 - Medical Supplies, Durable Medical Equipment, Orthoses, and Prosthesis Providers
Section 5160-10-25 - DMEPOS: lactation pumps
Universal Citation: OH Admin Code 5160-10-25
Current through all regulations passed and filed through September 16, 2024
(A) Definitions and explanations.
(1)
"Multiple-user lactation pump" is a lactation pump that
is safe for sequential use by multiple individuals. (The term "hospital-grade,"
which is often applied to such a pump, is not recognized by the United States
food and drug administration.) A multiple-user lactation pump comes with a
separate set of accessories (e.g., breast shields, tubing) for each individual,
which reduces the risk of contamination. It generally features adjustable
suction pressure and adjustable pumping speed. It is intended only for
temporary, short-term use.
(2)
The prescriber of
a lactation pump may be involved in the care of the individual woman, of the
infant, or of both.
(B) Coverage.
(1)
Payment may be
made for either or both of the following purposes:
(a)
Purchase of a
single-user manual or electric lactation pump as a medical supply item and
purchase of any necessary replacement supplies; or
(b)
Rental of a
multiple-user lactation pump.
(2)
For a single-user
manual or electric lactation pump, a prescription is sufficient. No separate
certificate of medical necessity (CMN) is needed.
(3)
For a
multiple-user lactation pump, the default CMN form is the ODM 01901,
"Certificate of Medical Necessity: Multiple-User Lactation Pumps" (rev.
1/2022).
(a)
On
the CMN, the prescriber explains and attests to the medical necessity of the
pump.
(b)
On the CMN, the prescriber specifies the expected
number of ninety-day rental periods. If additional rental periods are needed,
the prescriber may either revise the existing CMN or complete a new
CMN.
(C) Constraints and limitations.
(1)
The warranty period for a covered single-user manual or
electric lactation pump is one year from the date of delivery.
(2)
When a manual
lactation pump is supplied as part of a pump accessory kit, separate payment
will not be made for the manual lactation pump, nor will separate payment be
made for an additional manual lactation pump.
(3)
Payment for the
rental of a multiple-user lactation pump includes all accessories, supplies,
and cleaning.
(4)
ODM is not responsible for failure to return a
multiple-user lactation pump in working order.
Replaces: 5160-10-25
Disclaimer: These regulations may not be the most recent version. Ohio may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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