Or. Admin. Code § 410-148-0080 - Equipment Rental/Purchase/Repair

(1) The following equipment shall be covered, if medically appropriate and when cost effective, on a rental basis only:

(a) IV/Parenteral nutrition infusion pumps;

(b) Enteral nutrition infusion pumps;

(2) The equipment provider is responsible for providing working rental equipment including replacement if repairs are necessary.

(3) Rental payment for the enteral nutrition infusion pumps and the parenteral nutrition infusion pumps shall not be made beyond the purchase price or beyond fifteen (15) consecutive months (whichever is least costly).;

(a) Consecutive months are defined as "any period of continuous use where no more than a 60-day break occurs".

(b) Having met the purchase price, as described in this rule, the pump becomes the property of the client;

(A) The Division may allow for medically necessary repairs on equipment the patient owns when the repairs are not covered under any manufacturer/supplier warranty.

(B) The provider may bill the Division for maintenance and servicing of the pump (as long as the maintenance and servicing is not covered under any manufacturer/supplier warranty) when a period of at least six (6) months has elapsed since the final month of pump rental.

(C) Payment for the maintenance and servicing shall only be made one (1) time during every six (6) month period and only for actual incidents of maintenance and servicing.

(D) For a purchased pump, a rental pump may be covered for up to one (1) month during equipment repair for a client requiring medically necessary, continuous service. Use HCPCS code K0462 when billing for the temporary rental pump while the patient-owned pump is being repaired;

(4) Reasonable useful lifetime of an enteral nutrition infusion pump and parenteral nutrition infusion pump is no less than eight (8) years. Computation of the useful lifetime is based on the date the pump was dispensed to the client, not the age of the pump.

(5) All other equipment for home enteral/parenteral nutrition and IV services shall be covered as either purchase or based on length of need and medical appropriateness.

(6) All rental or purchase of equipment, full services warranty, pickup, delivery, set-up, fitting, and adjustments are included in the reimbursement. Individual consideration may be given in specific circumstances upon written request to the Division.

(7) Repair of rental equipment is the responsibility of the provider.

(8) The Division shall not make payment for rental of pumps that are supplied by any manufacturer at no cost to the provider.

Notes

Or. Admin. Code § 410-148-0080

HR 26-1990, f. 8-31-90, cert. ef. 9-1-90; HR 20-1991, f. & cert. ef. 4-16-91; HR 3-1995, f. & cert. ef. 2-1-95; OMAP 7-1998, f. 2-27-98, cert. ef. 3-1-98; OMAP 29-2000, f. 9-29-00, cert. ef. 10-1-00; OMAP 46-2001, f. 9-24-01, cert. ef. 10-1-01, Renumbered from 410-121-0700; OMAP 15-2004, f. 3-11-04, cert. ef. 4-1-04; OMAP 64-2004, f. 9-10-04, cert. ef. 10-1-04; DMAP 116-2024, amend filed 08/09/2024, effective 8/9/2024

Statutory/Other Authority: ORS 413.042

Statutes/Other Implemented: ORS 414.065