Indiana Administrative Code (Last Updated: December 20, 2016) |
Title 405. OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES |
Article 405IAC5. MEDICAID SERVICES |
Rule 405IAC5-19. Medical Supplies and Equipment |
Section 405IAC5-19-6. Durable medical equipment subject to prior authorization
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(a) Prior authorization by the office is required for all DME rented or purchased with Medicaid funds, except for the following:
(1) Cervical collars.
(2) Back supportive devices such as corsets.
(3) Hernia trusses.
(4) Oxygen and supplies and equipment for its delivery for nursing facility residents.
(5) Parenteral infusion pumps when used in conjunction with parenteral hyperalimentation, including central venous catheters.
(b) Prior authorization is required for oxygen concentrators, except when used for nursing facility residents who have been certified as needing oxygen services by a physician.
(c) All oxygen equipment and supplies, including concentrators and portable liquid oxygen equipment, require prior authorization for members in a home setting. The member's need for oxygen must be certified by a physician. (Office of the Secretary of Family and Social Services; 405 IAC 5-19-6; filed Jul 25, 1997, 4:00 p.m.: 20 IR 3330; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; readopted filed Sep 19, 2007, 12:16 p.m.: 20071010-IR-405070311RFA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFA; filed Aug 1, 2016, 3:44 p.m.: 20160831-IR-405150418FRA)