Durable Medical Equipment

Provider Representative:  Fidelia Williams-Edward Tel. (401) 648-3759

                                               email:fidelia.williams@gainwelltechnologies.com

Provider Reference Manual

Durable Medical Equipment Reference Manual  

Updates

• Prior Authorization for Durable Medical Equipment (DME)
• The Enteral Nutrition Guidelines can be found in the DME Reference Manual

Useful Information

Home Health Final Rule (2348-F) Effective July 1, 2017 

Below are details of the Home Health Final Rule (2348-F) from CMS, including Medicaid face-to-face requirements for home health services, policy changes, and clarifications related to home health and Durable Medical Equipment.  For more information click the following links:     

•   Medicaid Program: Face-to-Face Requirements for Home Health Services; Policy Changes and      Clarifications Related to Home Health- A Rule by the Centers for Medicare and Medicaid                  Services on 02/02/2016      
• DME Items:  Face to Face Requirement Effective 7/1/2017   

Durable Medical Equipment Reimbursement Effective July 1, 2012

The Rhode Island Executive Office of Health and Human Services, in conjunction with the State Fiscal Year 2013 Budget, have been directed to implement a new reimbursement rate for durable medical equipment.  The new rate is 85% of the Medicare Fee Schedule and will be effective retroactively to 7/1/2012.  Adjustments will take place during each of the five financial cycles of May through June 2013.  Should you have questions, please contact Customer Service at 401-784-8100 for local and long distance calls or 1-800-962-6411 for in-state toll calls and border communities.

Financial Cycle Date Months To Be Adjusted

 May 10, 2013July and August 2012 

 May 17, 2013September and October 2012

May 31, 2013November and December 2012

June 14, 2013January and February 2013

June 28, 2013March and April 2013