Conn. Agencies Regs. § 17b-262-680

Current through December 27, 2024

Section 17b-262-680 - Payment limitations

(a) Payment shall be made for customized DME for a client who dies or is not otherwise eligible on the date of delivery providing the client was eligible:

(1) on the date prior authorization was given by the department; or

(2) on the date the client ordered the item, if the item does not require prior authorization. For purposes of this section, the date the client orders the item means the date on which the written medical order for the item is presented to the provider. The provider shall verify to the department the date the client ordered the item.

(b) If the cost of repairs to any item exceeds its replacement cost, the item shall be replaced.

(c) The price for any item listed in the fee schedule published by the department shall include:

(1) fees for initial fittings and adjustments and related transportation costs;

(2) labor charges;

(3) delivery costs, fully prepaid by the provider, including any and all manufacturer's delivery charges with no additional charges to be made for packing or shipping;

(4) travel to the client's home, postage and handling, and set up or installation charges;

(5) technical assistance to the client to teach the client, or his or her family, the proper use and care of the equipment; and

(6) information furnished by the provider to the client over the telephone.

(d) Payment for servicing, repairs, or replacement of DME that are purchased by the department shall be contingent upon the exhaustion of any manufacturer's or dealer's warranty. The supplier shall first utilize existing warranties covering required servicing, repairs, and replacement.

(e) The department may pay for the rental of a wheelchair, for a period not to exceed three (3) months, in situations involving the pending delivery of a customized model to a client who resides in his or her own home.

(f) The department has the authority to determine the maximum rental period for DME, at which time the item shall be considered purchased. Such maximum rental periods shall be published on the fee schedule.

Conn. Agencies Regs. § 17b-262-680

Adopted effective August 22, 2000