23 Miss. Code. R. 209-1.11 - Augmentative Communication Device (ACD)

A. The Division of Medicaid defines an augmentative, or alternative, communication device (ACD) as any type of system that allows beneficiaries with severe, expressive communication disorders, or speech-language impairments, to overcome the disabling effects of communication impairment by representation of vocabulary or ideas and expression of messages.

B. The Division of Medicaid covers ACD's for all beneficiaries, when prior authorized by the Utilization Management/Quality Improvement Organization (UM/QIO), the Division of Medicaid, or a designated entity for rental up to the purchase amount, or purchase as indicated when the following criteria is met:

1. When ordered by a pediatrician, neurologist, or a physiatrist, a physician specializing in physical rehabilitation, and who has documented training in assessment for and prescription of ACD's.

2. Documentation that the beneficiary's ability to communicate using speech and/or writing is insufficient for communication purposes.

3. Documentation clearly supports that the beneficiary is mentally, emotionally, and physically capable of operating/using an ACD.

4. When the prescription includes specification for the ACD, component accessories, and all necessary therapies and/or training.

C. The Division of Medicaid requires an evaluation and recommendation be performed by a speech-language pathologist (SLP) in conjunction with other health professionals as appropriate.

1. A written copy of the evaluation and recommendation must be submitted with the request for prior authorization. This evaluation must include at a minimum:

a) Communication status and limitations, abilities to meet communication needs through other means such as sign language, manual communication, and the like,

b) Current speech and language skills,

c) Prognosis for speech and/or written communication,

d) Cognitive readiness, interactional/behavioral and social abilities,

e) Capabilities and needs including intellectual, including educational, postural, physical, sensory, including visual and auditory, motor, and cognitive,

f) Motivation to communicate,

g) Environmental, including residential, vocational and educational, assessment,

h) Current seating or positioning equipment and any modification that would be required secondary to the ACD,

i) Integration of communication with other behavior,

j) Alternative ACD(s) considered with comparison of capabilities,

k) Other communication methods/devices tried,

l) Ability of recommended ACD to be implemented/integrated into environments,

m) Ability to meet projected communication needs, like growth potential, projected length of time the beneficiary will be able to use the proposed system,

n) Anticipated changes, modifications, or upgrades with projected short and long-term time frames,

o) Anticipated prognosis with the specific device requested, and

p) Training plan including dates, names, addresses, and capabilities of available caregivers.

D. The Division of Medicaid allows for a trial period of at least thirty (30) days, not to exceed ninety (90) days, to ensure that the beneficiary's needs are met by the proposed ACD and in the most cost-effective manner.

E. The Division of Medicaid does not cover carrying cases separately.

Notes

23 Miss. Code. R. 209-1.11

42 U.S.C. § 1395m; Miss. Code Ann. §§ 43-13-117, 43-13-121.

Amended 8/1/2018