Common use of Exceptional Durable Medical Equipment Clause in Contracts

Exceptional Durable Medical Equipment. The CHC-MCO must provide Exceptional DME, as defined in Exhibit EE Covered Services. The CHC-MCO must operate a grant process to provide grants for Exceptional DME and Ventilators. The Department separately includes Exceptional DME from standard DME in its rate calculation. In the event of an Exceptional DME purchase, the equipment will belong to the Participant. An Exceptional DME/Ventilator grant is an authorization permitting exceptional payments under specified terms to a NF, in addition to the NF’s case-mix per diem rate, for NF services that are provided to a specified resident and that involve the use of certain exceptional DME and ventilator supplies. The amount of the additional payment authorized by a grant is based upon the necessary, reasonable and prudent cost of the Exceptional DME/Ventilators and the related services and items specified in the grant. The CHC-MCO must provide an Exceptional DME/Ventilator grant where the Exceptional DME/Ventilator is Medically Necessary and it must be specially adapted for the Participant or is on the Exceptional List. The Department will publish the Exceptional DME List and annual notice in the PA Bulletin. The CHC-MCO must provide a Ventilator grant where the ventilator equipment and supplies must be used for the unique Participant. The CHC- MCO must certify the ventilator units in the NF. The Department will publish the Ventilator Supply List and annual notice in the PA Bulletin.

Exceptional Durable Medical Equipment. The CHC-MCO must provide Exceptional DME, as defined in Exhibit EE A(1), Covered ServicesServices – Long-Term Services and Supports Service Definitions. The CHC-MCO must operate have a grant process to provide grants a separate payment for Exceptional DME and Ventilators. The Department separately includes Exceptional DME from standard DME in its rate calculationdeveloping the capitation rates. In the event of an Exceptional DME purchase, the equipment will belong to the Participant. An Exceptional DME/DME or Ventilator grant is an authorization permitting permits exceptional payments under specified terms to a an NF, in addition to the NF’s case-mix per diem rate, for NF services that are provided to a specified resident and that involve for the use of certain exceptional Exceptional DME and ventilator supplies. The amount of the additional payment authorized by a grant is based upon the necessary, reasonable reasonable, and prudent cost of the Exceptional DME/DME or Ventilators and the related services and items specified in the grantagreement with the NF. The CHC-MCO must provide provide, in accordance with then-existing Department policies and procedures, an Exceptional DME/DME or Ventilator grant payment where the Exceptional DME/DME or Ventilator is Medically Necessary and it must be specially adapted for the Participant or is on designated by the Exceptional ListDepartment. The Department will publish the an annual list of Exceptional DME List and annual by notice in the PA Pennsylvania Bulletin. The CHC-MCO must provide a Ventilator grant where , which shall be incorporated by reference and supersede the ventilator equipment and supplies must be used for the unique Participant. The CHC- MCO must certify the ventilator units current list of Exceptional DME set forth in the NF. The Department will publish the Ventilator Supply List and annual notice in the PA BulletinExhibit A(1).

Exceptional Durable Medical Equipment. ‌ The CHC-MCO must provide Exceptional DME, as defined in Exhibit EE A(1), Covered ServicesServices – Long-Term Services and Supports Service Definitions. The CHC-MCO must operate have a grant process to provide grants a separate payment for Exceptional DME and Ventilators. The Department separately includes Exceptional DME from standard DME in its rate calculationdeveloping the capitation rates. In the event of an Exceptional DME purchase, the equipment will belong to the Participant. An Exceptional DME/DME or Ventilator grant is an authorization permitting permits exceptional payments under specified terms to a an NF, in addition to the NF’s case-mix per diem rate, for NF services that are provided to a specified resident and that involve for the use of certain exceptional Exceptional DME and ventilator supplies. The amount of the additional payment authorized by a grant is based upon the necessary, reasonable reasonable, and prudent cost of the Exceptional DME/DME or Ventilators and the related services and items specified in the grantagreement with the NF. The CHC-MCO must provide provide, in accordance with then-existing Department policies and procedures, an Exceptional DME/DME or Ventilator grant payment where the Exceptional DME/DME or Ventilator is Medically Necessary and it must be specially adapted for the Participant or is on designated by the Exceptional ListDepartment. The Department will publish the an annual list of Exceptional DME List and annual by notice in the PA Pennsylvania Bulletin. The CHC-MCO must provide a Ventilator grant where , which shall be incorporated by reference and supersede the ventilator equipment and supplies must be used for the unique Participant. The CHC- MCO must certify the ventilator units current list of Exceptional DME set forth in the NF. The Department will publish the Ventilator Supply List and annual notice in the PA BulletinExhibit A(1).