Mississippi Administrative Code › Title 23 - Division of Medicaid › Part 209 - Durable Medical Equipment, Medical Appliances and Medical Supplies › Chapter 1 - Durable Medical Equipment and Medical Appliances › Rule 23-209-1.4 - Reimbursement

Current through June 25, 2024
A. The Division of Medicaid reimburses for
				durable medical equipment (DME) and/or medical appliances when ordered by a
				physician or through the use of a collaborative practice agreement between the
				non-physician practitioner and the physician, and within the practitioner's
				scope of practice and collaborative agreement procedures. [Refer to Miss.
				Admin. Code Part 207 for DME coverage in a long-term care facility.]
B. The Division of Medicaid requires prior
				authorization be submitted prior to or within thirty (30) days of delivery of
				the DME and/or medical appliance. The Division of Medicaid does not allow the
				beneficiary to be billed if the DME provider chooses to deliver the
				item/service prior to submitting a prior authorization request and approval is
				not given.
C. All standard DME
				and/or medical appliance, excluding custom motorized/power wheelchair systems,
				must have a manufacturer's warranty of a minimum of one (1) year.
1. If the provider supplies DME or a medical
				appliance that is not covered under a warranty, the provider is responsible for
				any repairs, replacement or maintenance that may be required within one (1)
				year.
2. The warranty begins on the
				date of the delivery to the beneficiary.
3. The DME provider must keep a copy of the
				warranty and repair information in the beneficiary's file.
4. The Division of Medicaid reserves the
				right to request copies of the warranty and repair information for audit/review
				purposes when necessary.
5. The
				Division of Medicaid investigates cases suggesting intentional damage, neglect,
				or misuse of the DME and/or medical appliance. If the provider suspects such
				damage of DME and/or medical appliance, the provider must report it immediately
				to the Division of Medicaid for investigation and notify the beneficiary that
				the cost for repairs/replacement may be the responsibility of the beneficiary
				if the Division of Medicaid determines intentional damage, neglect, or misuse
				of the DME and/or medical appliance.
6. DME providers must provide a two (2) year
				warranty of the major components for custom motorized/power wheelchairs.
a) The main electronic controller, motors,
				gear boxes, and remote joystick must have a two (2) year warranty from the date
				of delivery.
b) Cushions and
				seating systems must have a two (2) year warranty or full replacement for
				manufacturer defects, if the surface does not remain intact due to normal
				wear.
c) Powered mobility bases
				must have a lifetime warranty on the frame against defects in material and
				workmanship for the lifetime of the beneficiary.
d) If the DME provider supplies a custom
				motorized/power wheelchair that is not covered under a warranty, the provider
				is responsible for any repairs, replacement or maintenance that may be required
				within two (2) years.
e) The
				warranty begins the date of delivery to the beneficiary.