California Department of Social Services - State Hearings
Division
Notes from the Training Bureau - August 29, 2000
| Item 00-08-02D Changes in Definition of Durable Medical Equipment and Period of Validity for Authorization of Medi-Cal Benefits |
Changes in Definition of Durable Medical Equipment and Period of Validity for Authorization of Medi-Cal Benefits
Effective June 5, 2000, the California Department of Health Services made emergency amendments regarding Durable Medical Equipment (DME) and the Manual of Criteria for Medi-Cal Authorization. These amendments are found at Register 2000 Number 23 dated June 9, 2000.
Former Title 22 California Code of Regulations (CCR) §51160 defined DME as "equipment prescribed by a licensed practitioner to meet the medical needs of the patient". The revised definition of DME in §51160 is "Equipment that must be able to withstand repeated use, must be used to serve a medical purpose, must be appropriate for use in the patient's home, and must not be useful to an individual in the absence of an illness, injury or congenital anomaly".
The amendments also extend the period of validity for authorization of Medi-Cal benefits from 120 to 180 days. This amendment is reflected in Title 22 CCR §51003(e). When writing a decision granting a claim in a Medi-Cal scope of benefits case such as in a Dental scope case, judges should be sure that the boilerplate portion of the order allows for a 180-authorization period instead of 120 days.