Medicare Managed Care Manual (Pub. 100-16), Ch. 4 § 10.12

Durable Medical Equipment, Prosthetics, Orthotics and

Last amended: 2015Year: 2015Length: 109 wordsOfficial source
10.12 – Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) (Rev. 120, Issued: 01-16-15, Effective: 01-01-15, Implementation: 01-01-15) MA plans are required to “provide coverage of, by furnishing, arranging for, or making payment for, all services that are covered by Medicare Part A and Part B” (see 42 CFR 422.101(a)), which includes coverage of durable medical equipment, prosthetics and supplies. The MAO is responsible for maintaining continuity of care for its enrollee by ensuring uninterrupted access to the medically necessary covered DME item, including when the item needs to be repaired or replaced. If necessary, the MAO must purchase or rent a replacement item for the beneficiary to use.
Medicare Managed Care Manual (Pub. 100-16), Ch. 4 § 10.12: Durable Medical Equipment, Prosthetics, Orthotics and | Justis AI