La. Admin. Code tit. 40 § I-4113

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-4113 - Equipment Rental/Purchase Guidelines

A. Whenever the total of prospective rental payments for the period of medical need as stated by the prescribing physician equals or exceeds the maximum purchase price as set by the Office of Workers' Compensation Administration, the DME provider, prescribing physician and carrier/self-insured employer should recommend purchase instead of rental when communicating with the claimant. All items with a maximum allowable rate of $150 or less will be allowed as purchases only, regardless of the expected period of medical need. If, however, a definite period of medical need cannot be determined at the time of the initial prescription, a rental authorization will be granted with following condition.

1. Rented DME is considered purchased equipment once the Monthly Rental Allowance equals the Purchase Allowance. The DME is then owned by the claimant and neither claimant, nor insurer, nor employer can be billed.

B. If a claimant's medical condition changes or does not improve as expected, a rental may be discontinued in favor of a purchase. The carrier/self-insured employer reserves the right to reevaluate the rental/purchase option at any time within the authorized rental period.

C. If death or other factors intervene, rental fees for equipment will terminate at the end of the month such circumstances occurred and no further payment will be made regardless of the original rental period authorized.

D. The return of rented equipment is the dual responsibility of the claimant and the DME supplier. The carrier/self-insured employer is not responsible and will not reimburse for additional rental periods solely because of a delay in equipment return.

La. Admin. Code tit. 40, § I-4113

Promulgated by the Department of Labor, Office of Workers' Compensation, LR 19:54 (January 1993), repromulgated LR 19:212 (February 1993), amended LR 20:1299 (November 1994).

AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1034.2.