Durable Medical Equipment - Medicaid
Posted about 9 years ago by ANPA Admin
ANPA is committed to education for our NP community. Over the course of our growth, we hope to bring information to our members that is helpful and meaningful. This is our commitment to you!
Every once in a while, one of our members ask why a DME order is denies in Arkanas. While laws for the Center for Medicare and Medicaid Services (CMS) change on a Federal level, not all laws in Arkansas have been updated to align with them. Some of our members have had Medicaid DME orders denied because it "requires a physician order". Here is some information about this from the AANP State Governmental Affairs Department that may help clarify this (if this is really possible in the muddy waters of legislation, laws, and rules".
Statute:
(10)(A) "Healthcare service" means a healthcare procedure, treatment, or service: (i) Provided by a facility licensed in this state or in the state where the facility is located; or (ii) Provided by a doctor of medicine, a doctor of osteopathy, or by a healthcare professional within the scope of practice for which the healthcare professional is licensed in this state. (B) "Healthcare service" includes the provision of pharmaceutical products or services or durable medical equipment;
Ark. Code Ann. § 23-99-903
Arkansas Medicaid Website:
Medical Equipment
Equipment such as wheelchairs, oxygen tanks, and hospital beds that you use at home is called "durable medical equipment." Medicaid will pay for some durable medical equipment. You will need a prescription and a referral from your PCP.
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For children under 21, your doctor will need to get approval from Medicaid before you get certain equipment.
- If you are 21 or older, Medicaid will only pay for certain kinds of equipment. You will need a prescription from your PCP.
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