Section 17b-262-744 - Payment limitations(a) The department shall reimburse a provider when all requirements of sections 17b-262-736 to 17b-262-746, inclusive, of the Regulations of Connecticut State Agencies have been met.(b) The department shall pay for a customized orthotic or prosthetic device for a client who dies or is not otherwise eligible on the date of delivery provided the client was eligible: (1) on the date prior authorization was given by the department; or(2) on the date the client ordered the device, if the device does not require prior authorization. For purposes of this section, the date the client orders the device means the date on which the written medical order for the device is presented to or received by the provider. The provider shall verify to the department the date the client ordered the device.(c) If the cost of repairs to any orthotic or prosthetic device exceeds its replacement cost, the device shall be replaced.(d) The price for any device listed in the fee schedule published by the department shall include: (1) fees for initial fittings and all related subsequent adjustments;(3) delivery costs, fully prepaid by the provider, including any manufacturer's delivery charges, postage, packing and shipping;(4) all travel costs incurred by the provider associated with measurements, fittings, adjustments or repairs;(5) technical assistance fees related to teaching the client, his or her family or the designated representative the proper use and care of the equipment; and(6) fees for providing information to the client over the telephone.(e) The department shall pay for the servicing, repair or replacement of an orthotic or prosthetic device that is purchased by the department, provided that any manufacturer's or dealer's warranty has been exhausted. The provider shall first utilize existing warranties that cover required servicing, repairs and replacement.Conn. Agencies Regs. § 17b-262-744
Adopted effective January 1, 2003