Monday, November 16, 2015

#Waiverwise: Specialized Medicaid Equipment

Waiver services should be person centered. You will create a Service Plan within the budget limit ( $16,545 annually for FSW). There is more information available on this process in the waiver manual.

More information, including service costs, available in the manual:
http://provider.indianamedicaid.com/ihcp/manuals/DDRS%20HCBS%20Waiver%20Provider%20Manual.pdf

Specialized Medical Equipment and Supplies 

Specialized Medical Equipment and Supplies services are specialized medical equipment and supplies to include devices, controls, or appliances, specified in the POC, which enable individuals to increase their abilities to perform activities of daily living, or to perceive, control, or communicate with the environment in which they live and without which the individual would require institutionalization. Waiver services must approve all specialized medical equipment and supplies prior to service being rendered. 

Reimbursable activities under Specialized Medical Equipment and Supplies services include the following: 
 Items necessary for life support 
 Adaptive equipment and supplies 
 Ancillary supplies and equipment needed for the proper functioning of specialized medical equipment and supplies 
 Durable medical equipment not available under Medicaid State Plan 
 Non-durable medical equipment not available under Medicaid State Plan 
 Vehicle modifications 
 Communications devices 
 Interpreter services 

The following are limitations on Specialized Medical Equipment and Supplies services: 
 Service and repair up to $500 per year is permitted for maintenance and repair of previously obtained specialized medical equipment that was funded by a waiver service. If the need for maintenance exceeds $500, the Case Manager will work with other available funding streams and community agencies to fulfill the need. 
 A lifetime cap of $15,000 is available for vehicle modifications. In addition to the $15,000 lifetime cap, $500 will be allowable annually for repair, replacement, or an adjustment to an existing modification that has been provided through the HCBS waiver. If the lifetime cap is fully utilized, and a need is identified, the Case Manager will work with other available funding streams and community agencies to fulfill the need. 
 Vehicle Modifications have a cap of $7,500 under the Family Supports Waiver, but a cumulative lifetime cap of $15,000 across all HCBS waiver programs operated by the State.

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