Current through Register Vol. 41, No. 3, September 23, 2024
A. Service description. Assistive technology
(AT) service shall entail the provision of specialized medical equipment and
supplies including those devices, controls, or appliances specified in the
individual support plan but that are not available under the State Plan for
Medical Assistance that (i) enable individuals to increase their abilities to
perform activities of daily living (ADLs); (ii) enable individuals to perceive,
control, or communicate with their environment; (iii) actively participate in
other waiver services that are part of their plan for supports; or (iv) are
necessary for life support, including the ancillary supplies and equipment
necessary to the proper functioning of such items. The AT service shall be
covered in the FIS, CL, and BI waivers.
B. Criteria and allowable activities.
1. To qualify for the assistive technology
service, the individual shall have a demonstrated need for equipment for
remedial or direct medical benefit in the individual's primary home, primary
vehicle, community activity setting, or day program to increase his ability to
control his environment, support ISP outcomes as identified, and live safely
and independently in the least restrictive community setting. The AT service
shall be covered in the least expensive, most cost-effective manner and shall
be limited to $5,000 per calendar year. There shall be no carryover of unspent
funds from year to year. The covered equipment and activities shall include:
a. Specialized medical equipment and
ancillary equipment;
b. Durable or
nondurable medical equipment and supplies that are not otherwise available
through the State Plan for Medical Assistance;
c. Adaptive devices, appliances, and controls
that enable an individual to be independent in areas of personal care and ADLs;
and
d. Equipment and devices that
enable an individual to communicate more effectively.
2. Service requirements.
a. An independent professional consultation
to determine the level of need that is not performed by the AT service provider
shall be obtained from staff knowledgeable of that item for each AT service
request prior to approval by DMAS or its designee. Equipment, supplies, or
technology not available as durable medical equipment through the State Plan
for Medical Assistance may be purchased and billed as the AT service as long as
the request for such equipment, supplies, or technology is documented and
justified in the individual's ISP, recommended by the support coordinator,
service authorized by DMAS or its designee, and provided in the least
expensive, most cost-effective manner possible.
b. If required, a rehabilitation engineer or
certified rehabilitation specialist may be utilized if (i) the assistive
technology will be initiated in combination with environmental modifications
involving systems that are not designed to be compatible or (ii) an existing
device must be modified or a specialized device must be designed and
fabricated.
c. All AT service items
to be covered shall meet applicable standards of manufacture, design, and
installation.
d. The AT service
provider shall obtain, install, and demonstrate, as necessary, that the service
was authorized prior to submitting his claim to DMAS for reimbursement. The
provider shall provide all warranties or guarantees from the AT manufacturer to
the individual and family/caregiver, as appropriate.
C. Service units and limitations.
The AT service shall be available to individuals who are receiving at least one
other waiver service and may be provided in a residential or nonresidential
setting described in subdivision B 1 of this section. The AT service shall be
provided in the least expensive manner possible that will accomplish the
modification required by the individual enrolled in the waiver.
1. The maximum funded expenditure per
individual for all covered procedure codes (combined total of AT service items
and labor related to these items) shall be $5,000 per calendar year and shall
be completed within the calendar year. The service unit shall always be one for
the total cost of all AT service being requested for a specific
timeframe.
2. The AT service shall
not be approved for purposes of convenience of the caregiver, restraint of the
individual, or recreation or leisure activities.
3. AT service providers shall not be the
spouse, parent, or guardian of the individual enrolled in the waiver.
4. Requests for AT service via a DD Waiver
shall be denied if AT service is available for children under EPSDT
(12VAC30-50-130
). No duplication of payment for the AT service shall be permitted between the
waiver and services covered for adults that are reasonable accommodation
requirements of the Americans with Disabilities Act (
42 USC §
12101 et seq.), the Virginians with
Disabilities Act (Title 51.5 (§
51.5-1 et
seq.) of the Code of Virginia), and the Rehabilitation Act (
29 USC §
701 et seq.).
D. Provider qualifications and requirements.
1. Providers shall meet all of the
requirements of 12VAC30-122-110 through 12VAC30-122-140.
2. AT service shall be provided by
DMAS-enrolled durable medical equipment (DME) providers or DMAS-enrolled CSBs
or BHAs with a signed, current waiver provider agreement with DMAS to provide
the AT service. DME shall be provided in accordance with
12VAC30-50-165.
3. Independent assessments for the AT service
shall be conducted by independent professional consultants. Independent,
professional consultants include, for example, speech-language therapists,
physical therapists, occupational therapists, physicians, behavioral
therapists, certified rehabilitation specialists, or rehabilitation
engineers.
4. Providers that supply
AT service for an individual shall not perform assessment or consultation or
write specifications.
5. The plan
for supports and service authorization request shall include justification and
explanation if a rehabilitation engineer or certified rehabilitation specialist
is needed.
6. Providers shall
develop and maintain individual-specific documentation that supports the
provider's claims for payment. Claims that are not supported by
individual-specific documentation shall be subject to payment recovery actions
by DMAS.
7. Additional charges for
shipping, freight, or delivery are prohibited because these services are
considered all-inclusive in a provider's charge for the product.
8. All products must be delivered,
demonstrated, installed, and in working order prior to submitting any claim for
the products to Medicaid.
9.
Providers that supply the AT service for the waiver individual may not perform
assessments or consultation or write specifications for that individual. Any
request for a change in cost, either an increase or a decrease, requires
justification and supporting documentation of necessity and service
authorization by DMAS or its designee. The provider shall receive a copy of the
professional evaluation to purchase the items recommended by the professional.
If a change is necessary, then the provider shall notify the assessor to ensure
the changed items meet the individual's needs.
10. All equipment or supplies already covered
by a service provided for in the State Plan shall not be purchased under the AT
service.
E. Service
documentation and requirements.
1. Providers
shall include signed and dated documentation of the following in each
individual's record:
a. The service
authorization to be completed by the support coordinator may serve as the plan
for supports for the provision of AT service. The service authorization request
shall be submitted to DMAS or its designee in order for service authorization
to occur;
b. Written documentation
regarding the process and results of ensuring that the item is not covered by
the State Plan for Medical Assistance as durable medical equipment and
supplies;
c. Documentation of the
recommendation for the item by an independent professional
consultant;
d. Documentation of the
date services are rendered and the amount of service that is needed;
e. Any other relevant information regarding
the device or modification;
f.
Documentation in the support coordination record of notification by the
designated individual or individual's representative family/caregiver of
satisfactory completion or receipt of the service or item; and
g. Instructions regarding any warranty,
repairs, complaints, or servicing that may be needed.
2. Provider documentation shall support all
claims submitted for DMAS reimbursement. Claims for payment that are not
substantiated by supporting documentation shall be subject to recovery by DMAS
or its designee as a result of utilization reviews or audits.
Statutory Authority: §
32.1-325
of the Code of Virginia;
42 USC §
1396 et
seq.