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The rules say that plans must pay for a medical service or item if regular Medicare would pay for it in this case. You can find this rule at 42 Code of Federal Regulations (CFR) Section 422.101.
Medicare guidance says The supplier for all Durable Medical Equipment, Prosthetic, and Orthotic Supplies (DMEPOS) is required to keep on file a physician prescription (order). A supplier must have an order from the treating physician before dispensing any DMEPOS item to a beneficiary. All DMEPOS items other than those referenced in 42 CFR 410.38(c)(4) and 410.38(g)(2) require detailed written orders prior to billing. Detailed written orders may take the form of a photocopy, facsimile image, electronically maintained, or original pen-and-ink document. (See chapter 3, section 3.3.2.4). The written order must be sufficiently detailed, including all options or additional features that will be separately billed or that will require an upgraded code. The description can be either a narrative description (e.g., lightweight wheelchair base) or a brand name/model number. All orders must clearly specify the start date of the order. A written order prior to delivery is required for certain DMEPOS items as specified in 42 CFR 410.38(c)(4) and 410.38(g)(2). For these items, the supplier must have received a written order that has been both signed and dated by the treating physician/practitioner before dispensing the item. If a supplier bills for an item without a written order prior to delivery, the item will be denied. For a covered DME item, outlined in 42 CFR 410.38(g), the contractor shall ensure that the written order is consistent with requirements in 42 CFR 410.38(g)(4). This order must include, the beneficiary's name, the item of DME ordered, the NPI of the prescribing physician/practitioner, the signature of the prescribing physician/practitioner and the date of the order. If this information is not included on the written order, the claim will be denied. Medicare requires that the written order is completed after the face-to-face encounter. If the date of the written order is prior to the date of the face-to-face encounter, the contractor shall deny the claim. You can find this guidance in the Medicare Program Integrity Manual Chapter 5 - Items and Services Having Special DME Review Considerations, 5.2.1 - Physician Orders, 5.2.3 - Detailed Written Orders and 5.2.4 - Written Orders Prior to Delivery (A and C).C11. Medicare guidance says Per Medicare references listed below the rules state: "Section 424.57(c)(12) requires suppliers, as part of their standards to be met for enrollment and participation, to maintain proof of delivery documentation in their files. In certain instances, compliance with proof of delivery may be required as a condition of payment, and must be available to the DME MAC, RAC, SMRC, CERT, and ZPIC/UPIC on request. For such items, if the supplier does not have appropriate proof of delivery documentation within the prescribed timeframes, associated claims will be denied and overpayments recouped. We note that non-compliance with supplier standards may also result in revocation from the Medicare program. Suppliers who consistently do not provide documentation to support their services may be referred to the OIG or NSC for investigation and/or imposition of sanctions. If the beneficiary is newly eligible to the Medicare program, the proof of delivery standards require the supplier to obtain a statement, signed and dated by the beneficiary (or beneficiary's designee), that the supplier has examined the item." Also, "If the supplier utilizes a shipping service or mail order, an example of proof of delivery would include the service's tracking slip, and the supplier's own shipping invoice. If possible, the supplier's records should also include the delivery service's package identification number for that package sent to the beneficiary. The shipping service's tracking slip should reference each individual package, the delivery address, the corresponding package identification number given by the shipping service, and if possible, the date delivered. If a supplier utilizes a shipping service or mail order, suppliers shall use the shipping date as the date of service on the claim.". You can find this guidance in the Medicare Program Integrity Manual, Chapter 5, Section 5.8 - Supplier Documentation; CMS Manual System Pub 100-08, Medicare Program Integrity Transmittal 635, 4.26.1 - Proof of Delivery and Delivery Methods.
If you want to read these Medicare rules, you can go to this website www.medicareappeal.com.