Kan. Admin. Regs. § 129-5-108

Current through Register Vol. 43, No. 46, November 14, 2024

Section 129-5-108 - Scope of services for durable medical equipment, medical supplies, orthotics, and prosthetics

(a) Selected durable medical equipment (DME) shall be available to each beneficiary, with the following limitations:

(1) The DME shall be the most economical to meet the beneficiary's need.

(2) The least expensive and most appropriate method of delivery shall be used. If round-trip delivery is over 100 miles, prior authorization shall be required.

(3) Used equipment with a warranty specified by the agency shall be used if available.

(4) Certain DME designated by the agency shall be the property of the agency.

(5) Educational, environmental control, and convenience items shall not be covered.

(6) DME shall be covered for only the following types of beneficiaries:

(A) Participants in the Kan Be Healthy program;

(B) beneficiaries who require the DME for life support;

(C) beneficiaries who require the DME for employment; and

(D) beneficiaries who would require more expensive care if the DME was not provided.

(7) DME services provided for the parenteral administration of total nutritional replacements and intravenous medication in the beneficiary's home shall require the provision of services by a local home health agency, physician, advanced registered nurse practitioner, physician assistant, or pharmacist.

(b) Selected medical supplies shall be available to each beneficiary for use in the beneficiary's home.

(c) Selected DME and medical supplies shall be considered for coverage only in cases in which exceptional hardship or medical need has been justified by documentation of medical necessity or by the granting of prior authorization.

(d) Orthotics and prosthetics shall be available to program beneficiaries from orthotic and prosthetic dealers enrolled under K.A.R. 30-5-59.

Kan. Admin. Regs. § 129-5-108

Authorized by K.S.A. 2007 Supp. 75-7403 and 75-7412; implementing K.S.A. 2007 Supp. 75-7405 and 75-7408; effective Nov. 17, 2006; amended Sept. 19, 2008.