Alerts

Durable Medical Equipment (DME) Program Updates Related to COVID-19

8/18/2020


TO:  DME Providers, Prosthetics & Orthotics (P&O) Providers, Pharmacies,
Physicians, Physician Assistants, Nurse Practitioners, and Nursing Homes

During the time prescribed by the governor as a state of emergency due to the COVID-19 pandemic, the following Rule provisions are temporarily lifted:

   1.  Rule requiring EPSDT referrals for prior authorizations for any Durable Medical Equipment (DME), Supplies, Appliances, Prosthetics, Orthotics, and Pedorthics. This includes, but is not limited to, those provisions of the Administrative Code found in Rules 560-X-13-.03, .14, and .17.

   2.  Rule requiring face-to-face visits for DME items. This includes, but is not limited to, those provisions of the Administrative Code found in Rule 560-X-13-.01. In lieu of face-to-face visits, providers should utilize telehealth systems.

   3.  Rule requiring a prescription or order for DME items to be presented to the provider or Medicaid’s fiscal agent within 90 days from the date it was written, and sections which require a prior authorization request for DME to be received by the Medicaid fiscal agent within 30 calendar days after equipment is dispensed. This includes, but is not limited to, those provisions of the Administrative Code found in Rule 560-X-13-.03.

   4.  Rule requiring only a physician to write the initial prescription for DME items ordered during face-to-face visits. This includes, but is not limited to, those provisions of the Administrative Code found in Rule 560-X-13-.01. To clarify, authorized non-physician practitioners such as nurse practitioners or physician assistants may write the initial prescription for DME items ordered during face-to-face/telehealth visits.

   5.  Rule requiring recipient signature for all DME, Supplies, Appliances, Prosthetics, Orthotics, and Pedorthics. This includes, but is not limited to, those provisions of the Administrative Code found in Rule No. 560-X-1-.18. Recipient signatures are not required in cases where the provider has discontinued signature capture due to health concerns. The provider must maintain documentation of services provided to the recipient.

Rule questions concerning this provider notice should be directed to the DME Program at (334) 242-5050.


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