Petitioner bore the burden of proving that she was entitled to the requested services under Medicaid (see 18 NYCRR 513.3 [a]; see alsoMatter of Whittier Health Servs., Inc. v. Pospesel , 133 A.D.3d 1176, 1177–1178, 20 N.Y.S.3d 240 [2015] ). Although a recipient of Medicaid benefits must establish that a requested medical service or supply is medically necessary (see 18 NYCRR 513.3 [a]; see also 18 NYCRR 513.6 [a][3]; see generallyMatter of Layer v. Novello , 17 A.D.3d 1123, 1125, 795 N.Y.S.2d 810 [2005] ; Matter of Marion v. Balch , 252 A.D.2d 915, 917, 676 N.Y.S.2d 712 [1998] ; Matter of Johnson v. Wing , 237 A.D.2d 960, 960, 654 N.Y.S.2d 902 [1997] ), Medicaid does not cover every medically necessary procedure; "medical necessity and coverage are distinct concepts" ( DeSario v. Thomas , 139 F.3d 80, 93 [2d Cir.1998] ["for Medicaid payment to be proper, the item or service furnished must be both covered and medically necessary"], judgment vacated on different grounds sub nom.Slekis v. Thomas , 525 U.S. 1098, 119 S.Ct. 864, 142 L.Ed.2d 767 [1999] )

The evidence is uncontroverted that petitioner has difficulty manipulating manual overlays and consequently is often unable to express his immediate needs to facility staff and family. On this record respondent's determination that the Dynamite 3100 is not medically necessary is not supported by substantial evidence ( see, Matter of Johnson v. Wing , 237 A.D.2d 960;Matter of Gartz v. Wing , 236 A.D.2d 890; Matter of Dobson v.Perales , 175 A.D.2d 628).

The Administrative Law Judge (ALJ) upheld the denial of funding, noting that the new wheelchair would be better for petitioner, but concluding that petitioner had not established that it was medically necessary. He further concluded that petitioner's current wheelchair could be modified with a new seating system and could have elevating leg rests and adjustable arm rests added. We agree with petitioner that respondent's determination that the new wheelchair is not medically necessary is not supported by substantial evidence ( see, Matter of Johnson v. Wing, 237 A.D.2d 960; Matter of Gartz v. Wing, 236 A.D.2d 890; Matter of Dobson v Perales, 175 A.D.2d 628). Petitioner established that the new wheelchair would prevent skin breakdown, decubitus ulcers and edema, would enable her to push the chair more easily without the need to lean forward, would provide better support and prevent back, shoulder and neck pain, and would allow her to fit through the doorway to the bathroom. Respondent presented no proof to the contrary.