MEMORANDUM

DISCUSSION:

Memo IM #35, dated 06/17/2011, announced the end of proration of expenses for durable medical equipment on June 1, 2011. The purpose of this memorandum is to clarify procedures for determining the date the expense of durable medical equipment is incurred.

In an instance where the participant is issued the durable medical equipment and then billed at a later date, the date the expense is incurred is the date the equipment is issued to the participant and then the first of the month for each month thereafter.

EXAMPLE: Mary Jones is issued an oxygen concentrator on June 1.  An invoice is sent to her for the use of the equipment.  The date the expense is incurred is June 1.

Request and obtain documentation from the care provider verifying the issuance date of the equipment, clarification of the billing cycle and what the patient responsibility is.  This includes verifying if the participant has other health insurance or Medicare that will be paying for all or part of the expense.  To meet spenddown, only allow the part of the expense that the participant is responsible for paying.

The Income Maintenance policy manual section:  0810.010.15.05 has been updated to reflect this change.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Effective immediately, allow the incurred expense date of durable medical equipment to be the date the equipment is put in use and/or the first of the month thereafter.

HA