Attention DME Providers Hurricane Dorian - DMEPOS Policy Flexibility on Replacing Medical Equipment

Per clinical coverage policies 5A-1, 5A-2, 5A-3 section 5.9 and 5B, section 5.7.3:

Medicaid or NCHC may consider replacing the item, when repairing is no longer cost-effective and the item is out of warranty. Refer to Attachment A, Section C: Procedure Codes(s).

Note: When requesting prior approval for the replacement of an item before its usual life expectancy has ended, explain on the CMN/PA form why the replacement is needed. Specific documentation, in addition to the prescription and CMN/PA form, is required in the following situations:

a. In cases of equipment loss or damage beyond repair, a letter from the social worker, case manager or child service coordinator explaining the circumstances.

b. In cases of theft, a copy of the police report or a letter from the appropriate person with knowledge of the occurrence, such as the school principal, social worker, etc.

c. In cases of equipment destruction by fire, a copy of the fire report.

For equipment loss or damage due to Hurricane Dorian, GDIT has been instructed to accept documentation from any of the entities listed above and from the NC Division of Emergency Management, Federal Emergency Management Agency, American Red Cross or other appropriate state or local authorities and agencies on the ground in the affected areas including the National Guard, fire and police departments.