Section 17b-262-799 - Payment and payment limitations(a) Fees shall be the same for in-state, border-state and out-of-state providers.(b) Payment shall be made at the lowest of: (1) The provider's usual and customary charge;(2) the lowest Medicare rate;(3) the amount in the applicable fee schedule as published by the department pursuant to section 4-67c of the Connecticut General Statutes; or(4) the amount billed by the provider.(c) The department shall reimburse a provider when all the requirements of sections 17b-262-792 to 17b-262-803, inclusive, of the Regulations of Connecticut State Agencies have been met.(d) The fee for a hearing aid includes an initial one-year manufacturer's warranty against loss, theft or damage.(e) Hearing aids provided shall be new and guaranteed against all defects in workmanship and materials for at least one year from the date of delivery of the hearing aid to the client.(f) The department shall pay providers for:(1) The actual acquisition cost of a hearing aid to the provider up to the maximum amount allowed by the department's fee schedule;(2) a dispensing fee up to the maximum allowed by the department's fee schedule; and(3) hearing testing for the purpose of fitting a hearing aid.(g) The department shall pay for custom ear molds for a client who dies or is not otherwise eligible on the date of delivery provided the client was eligible on the date the item was ordered.(h) If the cost of repairs to any hearing aid exceeds its replacement cost, the hearing aid shall be replaced.(i) The provider shall meet the exact specifications of a hearing aid selected by an audiologist, ear specialist or licensed practitioner.Conn. Agencies Regs. § 17b-262-799
Adopted effective July 11, 2011