N.J. Admin. Code § 10:59-1.11

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:59-1.11 - Recycling durable medical equipment

(a) The New Jersey Medicaid and NJ FamilyCare programs shall utilize the services of a durable medical equipment (DME) recycling contractor, acting as an agent of the State, to recycle certain DME for reuse by Medicaid and NJ FamilyCare fee-for-service beneficiaries when such equipment is considered medically necessary.

(b) The New Jersey Medicaid and NJ FamilyCare fee-for-service programs shall recycle certain DME when the aggregate cost of recycling an item of DME, including costs for pickup and delivery, repairs, maintenance, tracking of DME and other directly related costs, are less than the Medicaid/NJ FamilyCare maximum fee allowance for the purchase of new DME.

1. Coverage and reimbursement for DME which is determined recyclable by the New Jersey Medicaid and NJ FamilyCare fee-for-service programs shall be limited to such equipment when this equipment is available from the DME recycling contractor.

2. Recyclable DME shall include, but not be limited to, the following:

i. Canes, all types;

ii. Commodes;

iii. Communication devices;

iv. Crutches, all types;

v. Durable bathroom equipment;

vi. Hospital beds, all types;

vii. Walkers, all types;

viii. Wheelchairs and wheelchair components.

(c) Prior to dispensing equipment determined recyclable by the State, medical suppliers shall contact the DME recycling contractor to determine the availability of recycled equipment for reuse. Reimbursement for recycling used equipment shall be limited to services provided by the recycling contractor.

(d) Claims for new DME, when such DME is readily available from the DME recycling contractor, shall be denied reimbursement by the Medicaid and NJ FamilyCare fee-for-service programs.

(e) Medical suppliers in receipt of used DME which is considered recyclable by the Medicaid and NJ FamilyCare programs shall arrange for the return of such equipment to the DME recycling contractor by contacting the contractor directly.

N.J. Admin. Code § 10:59-1.11

Repeal and New Rule, R.1999 d.176, effective 6/7/1999 (operative July 1, 1999).
See: 30 N.J.R. 4033(a), 31 N.J.R. 1506(a).
Section was "Recycling policy".
Amended by R.2006 d.297, effective 9/5/2006.
See: 38 N.J.R. 1371(b), 38 N.J.R. 3578(a).
Substituted "Family Care" for "KidCare" throughout; and in (b), inserted "/NJ FamilyCare".