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Colorado Administrative Code
Department 2505 - Department of Health Care Policy and FinancingDivision 2505 - Medical Services Board (Volume 8; Medical Assistance, Children's Health Plan)
Rule 10 CCR 2505-10-8.7000 - CREATION OF MEDICAL ASSISTANCE ACT SECTION 7.000 CONCERNING CASE MANAGEMENT, MEMBER RIGHTS AND RESPONSIBILITIES HOME AND COMMUNITY BASED SERVICES AND PROVIDER AGENCY REQUIREMENTS
Section 10 CCR 2505-10-8.7547 - Specialized Medical Equipment and Supplies

10 Colo. Code Regs. § 2505-10-8.7547

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Current through Register Vol. 47, No. 24, December 25, 2024
Section 10 CCR 2505-10-8.7547 - Specialized Medical Equipment and Supplies
8.7547.ASpecialized Medical Equipment and Supplies Eligibility
1. Specialized Medical Equipment and Supplies (SMES) is a covered benefit available to Members enrolled in one of the following HCBS waivers:
a. Brain Injury Waiver
b. Children's Extensive Support Waiver
c. Developmental Disabilities Waiver
d. Supported Living Services Waiver
8.7547.BSpecialized Medical Equipment and Supplies Definition
1. Specialized Medical Equipment and Supplies means devices, controls, or appliances that help the Member perceive, control, or communicate with their environment to increase their ability to perform Activities of Daily Living or remain safely in their home and community.
8.7547.CSpecialized Medical Equipment and Supplies Inclusions
1. Specialized Medical Equipment and Supplies is authorized for Organized Health Care Delivery System (OHCDS).
2. Specialized Medical Equipment and Supplies include devices, controls, or appliances that help the Member perceive, control, or communicate with their environment to increase their ability to perform Activities of Daily Living or remain safely in their home and community.
3. Devices, controls or appliances that enable the Member to increase their ability to perform Activities of Daily Living,
4. Devices, controls or appliances that enable the Member to perceive, control or communicate within their environment,
5. Items necessary to address physical conditions along with ancillary supplies and equipment necessary to the proper functioning of such items;
6. Durable and non-durable medical equipment not available under the Medicaid State Plan that is necessary to Member's needs assessed in the Person-Centered Support Plan;
7. Necessary medical supplies in excess of Medicaid State Plan limitations or not available under the Medicaid State Plan.
8. Maintenance and upkeep of specialized medical equipment purchased through the HCBS waiver.
9. All items shall meet applicable standards of manufacture, design and installation.
10. HCBS Supported Living Services Waiver, Children's Extensive Supports Waiver
a. Kitchen equipment required for the preparation of special diets if this results in a cost savings over prepared foods;
b. Specially designed clothing for a Member if the cost is over and above the costs generally incurred for a Member's clothing.
8.7547.DSpecialized Medical Equipment and Supplies Exclusions and Limitations
1. Specialized Medical Equipment and Supplies excludes those items that are not of direct medical or remedial benefit to the Member as assessed through their Person-Centered Support Plan.
2. Durable and non-durable medical equipment available under the Medicaid State Plan
3. Items that are not of direct medical or remedial benefit to the Member include vitamins, food supplements, any food items, prescription or over the counter medications, topical ointments, exercise equipment, hot tubs, water walkers, resistance water therapy pools, experimental items and wipes for any purpose other than incontinence are not covered under this service.

10 CCR 2505-10-8.7547

47 CR 03, February 10, 2024, effective 3/16/2024
47 CR 21, November 10, 2024, effective 11/30/2024