Rule 37.86.1801 - PROSTHETIC DEVICES, DURABLE MEDICAL EQUIPMENT, AND MEDICAL SUPPLIES, DEFINITIONS(1) "Durable medical equipment and supplies" means the most economical equipment or supplies that are medically necessary to treat a health problem or a physical condition. The equipment or supplies must be appropriate for use in any setting in which life activities take place, as defined at 42 CFR 440.70(c)(1) (2018). Equipment or supplies that are useful or convenient, but are not medically necessary to treat an illness or injury do not qualify for Medicaid coverage.(2) "Prescription" means a prescription or order as provided in ARM 37.86.1802.(3) "Prior authorization" means the Medicaid program's review and approval of an item's medical necessity and coverage by Medicaid prior to the delivery of the item.(4) "Prosthetic devices" means replacement, corrective, or supportive devices or appliances which artificially replace a missing portion of the body to: (a) prevent or correct physical deformity or malfunction; or(b) support a weak or deformed portion of the body.Mont. Admin. r. 37.86.1801
NEW, Eff. 11/4/74; AMD, 1981 MAR p. 559, Eff. 6/12/81; AMD, 1981 MAR p. 1977, Eff. 1/1/82; AMD, 1986 MAR p. 1911, Eff. 1/1/87; AMD, 1992 MAR p. 1872, Eff. 8/28/92; TRANS, from SRS, 2000 MAR p. 481; AMD, 2007 MAR p. 2134, Eff. 1/1/08; AMD, 2008 MAR p. 2672, Eff. 1/1/09; AMD, 2018 MAR p. 1608, Eff. 8/11/2018AUTH: 53-2-201, 53-6-113, MCA; IMP: 53-6-101, 53-6-141, MCA