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Provider Notice Issued 09/12/2018
Date: September 12, 2018
To: Providers of Long Term Care (Nursing Facilities only)
Re: Motorized Wheelchairs ______________________________________________________________________
This Notice supersedes a July 26, 2011, Provider Notice. This Notice informs providers that they are not required to report the names and number of Nursing Facility (NF) residents who are provided with a motorized wheelchair. However, residents must continue to have access to motorized wheelchairs if medically-necessary as determined by the resident’s physician.
NFs that serve Medicaid-eligible individuals continue to be responsible for ensuring their residents have access to motorized wheelchairs as needed.
Non-custom electric wheelchairs are provided by the NF as part of their Medicaid per diem. As with other non-custom Durable Medical Equipment (DME), the cost of the chair is reported on the NF’s Cost Report and used to calculate the Medicaid per diem. The NF retains ownership when a resident no longer requires the wheelchair.
Prior Approval of custom motorized wheelchairs may be requested by a DME provider through Healthcare and Family Services Bureau of Professional and Ancillary Services DME Unit. If the resident meets the eligibility criteria for custom equipment, HFS will pay for the wheelchair. The resident retains ownership of a custom electric wheelchair upon their discharge. Eligibility criteria for custom DME is similar to that used by Medicare.
If a resident is enrolled in one of the Medicaid Managed Care Plans, a Prior Approval request for custom DME must be made to that Plan.
This process mirrors that of other medically-necessary DME required by NF residents.
Questions regarding this notice may be directed to the Bureau of Long Term Care at
1-844-528-8444.
Teresa T. Hursey
Medicaid Administrator