Section 17-1737-72 - Durable medical equipment(a) Durable medical equipment means equipment prescribed by a licensed physician to meet the medical equipment needs of a patient. Durable medical equipment includes, but is not limited to, wheelchairs, walkers, crutches, canes, hospital beds, side rails, respirators, and oxygen equipment.(b) Durable medical equipment may be provided if it is: (1) A medically necessary modality in the treatment of a medical condition;(2) Necessary to assist the recipient in meeting or improving activities of daily living;(3) Recommended by the attending physician for medical care of a patient; or(4) Suitable for use in the recipient's place of residence.(c) Ramps for wheelchairs may be provided with prior authorization when necessary to accomplish activities of daily living.(d) Not more than one wheelchair of any kind is allowed, unless there is a significant change in the recipient's condition that justifies another wheelchair.(e) Medical equipment or appliances, when not available in the department's inventory, may be provided through rental or purchase, depending on the physician's opinion about the length of time the recipient will require use of the equipment.(f) Rental payment for durable medical equipment or appliances shall cease and the item will have been purchased by the state when rental payments become equal to the purchase price.(g) When an item is purchased during a rental period but before the rental paid equals the purchase price, all rental payments will be credited toward the purchase price of that item.(h) Durable medical equipment shall not be provided to recipients who are patients in acute hospitals or long-term care facilities.(i) Medical authorization shall be required for the purchase, cumulative rental, or repair of durable medical equipment when the cost to the program exceeds $50 per month.(j) The following items shall not be covered by the medical assistance program: (5) Household items and furnishings including standard, orthopedic, or water beds;(7) Air purifiers or air filters;(10) DME modifications to the house, which may include, but is not limited to, ceiling lifts, wheelchair lifts, elevators, and stair climbers;(11) Feeder chairs when the recipient has another seating system, such as a wheelchair;(12) Car seats and booster seats for individuals of all ages;(13) Infant or child strollers;(14) High chairs or chairs used for feeding; and(15) Other items not generally used primarily for health care.(k) The medical consultant may change a request for durable medical equipment to a less expensive make or model when the basic functions of the desired equipment are met.(l) Durable medical equipment purchased by the Medicaid program may be re-claimed by the department when no longer useful to the client.(m) Medicare's criteria is followed for the coverage of durable medical equipment unless specifically stated elsewhere. This provision also applies to the maintenance, replacement, and repair of durable medical equipment. Haw. Code R. § 17-1737-72
[Eff 08/01/94; am 10/26/01, am 05/10/03; am 09/17/07 ] (Auth: HRS § 346-14) (Imp: 42 C.F.R. §§440.110, 440.130 )