Or. Admin. Code § 411-016-0200

Current through Register Vol. 64, No. 1, January 1, 2025

Section 411-016-0200 - Special Medical Equipment and Supplies

(1) Individuals may be eligible for specialized or durable medical equipment and medical supplies if no other payer such as Medicare, Medicaid medical benefits or other insurance is paying for the equipment or supplies.

(2) Special medical equipment or supplies must be necessary to support the consumer's health or well-being. Special medical equipment is not assistive technology as defined in OAR 411-016-0005 and is not a replacement or substitute for caregiver or unpaid caregiver services.

(3) Special medical equipment or supplies must be prior authorized in accordance with OAR 411-035-0015 (2-6).

(4) To be considered an eligible request, when possible, three bids are required from providers. Consumers should work with their Services Case Manager to obtain bids. Bids may not include comparative pricing done through the internet.

(5) Special medical equipment or supplies must be approved by Central Office.

(6) No monetary funds shall be released for installation of special medical equipment or supplies to the provider until the work is finished and is functioning as expected.

(7) Upon delivery, providers must ensure:

(a) The product is functioning correctly;

(b) The product properly fits the consumer; and

(c) If applicable, the individual is given adequate instruction on the product's use.

(8) Providers must supply a revised bid when requested by designated Central Office staff.

(9) Providers must submit the final invoice for payment within one year of the date of service.

Or. Admin. Code § 411-016-0200

APD 22-2024, temporary adopt filed 05/20/2024, effective 5/31/2024 through 11/26/2024; APD 64-2024, adopt filed 11/20/2024, effective 11/22/2024

Statutory/Other Authority: ORS 410.070

Statutes/Other Implemented: ORS 410.020 & 410.070