23 Miss. Code. R. 209-1.44 - Ventilator

A. Medicaid defines a ventilator as a mechanical device used for artificial ventilation of the lungs.

B. Medicaid covers ventilators for all beneficiaries when prior authorized by the Utilization Management and Quality Improvement Organization (UM/QIO), the Division of Medicaid or designated entity, for rental only, and ordered by a physician and one (1) of the following criteria is met:

1. The beneficiary is unable to maintain spontaneous respiration.

2. The beneficiary is unable to maintain safe levels of arterial carbon dioxide or oxygen with spontaneous breathing.

3. The beneficiary has a medical condition that requires mechanically assisted ventilation that is appropriate for home use, without continuous technical or professional supervision.

C. Medicaid covers the rental allowance which includes:

1. The equipment,

2. Delivery,

3. Freight and postage,

4. Set-up,

5. All supplies necessary for operation of the equipment,

6. Education of the patient and caregiver,

7. All maintenance and repairs or replacement,

8. Labor including respiratory therapy visits, and

9. Servicing charges.

Notes

23 Miss. Code. R. 209-1.44

42U.S.C. § 1395m; Miss. Code Ann. §§ 43-13-117(17), 43-13-121.

Amended 9/1/2018