10.1 Scope and Definitions
The standards in this chapter apply to the purchase in whole or in part
of durable medical equipment on behalf of eligible consumers by the Department
of Assistive and Rehabilitative Services (DARS).
Durable Medical Equipment. The following are definitions for
different types of durable medical equipment.
- Power wheelchairs (fully functional chairs): A power wheelchair is battery-operated. It has a base with four wheels, adjustable seat with armrests, and a controller (joystick or touch pad) attached to one armrest that allows the rider to control the movement of the chair. It can be
disassembled for transport and usually comes with an on-board battery charger. The braking system is either automatic or electric. Powered wheelchairs can be customized with advanced technology, and with several options including seat size (width and depth), seat-to-floor height, foot rests, and leg rests.
- Manual wheelchairs (fully functional chairs): A standard manual wheelchair
may have a cross-brace frame, which enables the frame to easily fold for transport or storage,
or may be nonfolding, having a rigid frame. It may have built-in or removable armrests
or footrests (optional) for ease of transfer, a mid- to high-level back, and push handles to allow nonoccupants to propel the chair. The seat sizes may be customized for the
user. The standard tire used for the rear wheels on most wheelchairs is a pneumatic tire, with a standard size of 24 inches. It has wheel locks, sometimes called brakes,
which can be applied by pushing a lever located on the sides, allowing the user to control the speed or come to complete stop.
- Scooters: A scooter is a power-operated vehicle (POV) that has a seat on a long platform, moves on either three or four wheels, is controlled by a steering handle, and can be independently driven by a
user. It has rear drive, uses a 24-volt system and an electronic or dynamic braking system, has high-to-low speed settings, and has tires designed for indoor and outdoor use.
- Power units and controllers: A power unit and controller is a computer peripheral or general control device consisting of a hand-held stick that pivots about one end and transmits its angle in two or three dimensions to a computer, or a touch pad that serves the same purpose. It is used to propel, brake, steer, negotiate, and maneuver a powered wheelchair or scooter around obstacles.
- Seating or positioning systems: A wheelchair seating system is designed for the individual needs of the consumer to
- provide postural support, thereby enabling the consumer to sit when the consumer does not have sufficient strength or control to do so unaided;
- provide correction to encourage normal postural development and to reduce the tendency to develop orthopedic deformities;
- enhance functionality, enabling the consumer to perform everyday tasks in a workplace or social setting in which the consumer would not otherwise be able to perform those tasks;
- manage the distribution of pressure to reduce the risk of tissue damage resulting from inappropriate loads being applied to the skin; and
- accommodate established orthopedic deformities.
The actual components and complexity of any particular wheelchair seating system depend on the problems that the system addresses. This definition includes parts (for
example, cushions), as well as the complete system.
- Patient lifts: Patient lifts are assistive devices used to
help caregivers transfer a person safely back and forth from a bed to a chair when the
person cannot transfer without assistance. Lifts fall into four broad categories: mobile lifts, sit-to-stand lifts, ceiling lifts, and wall-mounted lifts. The lifts can be operated hydraulically or electronically. For the purpose of DARS contracts, this definition does not include
- lifts that require structural modification of a building; or
- lift chair recliners, sometimes referred to as easy chairs, with seats that raise an occupant to a standing position.
- Hospital beds: A hospital bed consists of a modified catch-spring assembly and bed ends with casters and manually operated foot-end cranks, or an electric motor, that permits independent adjustment of the elevation of the head and knee sections. The bed can accommodate a standard trapeze bar when attached to the head end and other accessories. The bed should be equipped to accommodate side rails. This definition does not include special or customized mattresses.
Fabricated Good: A fabricated good is a device constructed to meet a specific need.
Functional Unit: A functional unit is the fully constructed or fabricated durable medical
equipment unit that can be immediately used by the DARS consumer for whom it was specified. For example, a wheelchair would include the frame, seating system, controls, batteries, or other parts necessary to make it immediately usable by the consumer.
Manufacturer's Suggested Retail Price (MSRP): The MSRP is the manufacturer's published suggested retail price.
Other Medical Goods and Supplies: Other medical goods and supplies are all medical goods and supplies not defined as durable medical
Contractor-Provided Specification: A contractor-provided specification is a written detailed description of the exact product to be provided, including the cost of the product and the date by which the product will be delivered.
10.2 Description of Goods and Services
Durable medical equipment is rendered by contractors who agree to
- provide new or unused durable medical equipment specified on a DARS service authorization and/or purchase order at the rate established in 10.3 Documentation and Fees;
- determine specific equipment needs by conducting an evaluation at the consumer's home and/or worksite if current and appropriate specifications are unavailable and
the evaluation is requested by DARS (these evaluations must be made at
no cost to DARS);
- deliver to the specified address on the date and time mutually agreed upon by the counselor, consumer, and contractor within 30 to 45 days of the service authorization and/or purchase order date, or notify the DARS buyer of the estimated delivery date before the service authorization and/or purchase order is issued;
- deliver the product in an assembled and fully functional state, including adaptations or fabrication of parts (parts and labor) necessary to meet the described individual needs of the DARS consumer (customized fabrication of parts is subject to the prior review of schematics or other descriptive material, and approval of the counselor
- provide operation and maintenance instruction to the DARS consumer;
- provide preventive maintenance, as applicable, to the product at the end of the 6th and 12th months of operation (if the product is still in the possession of the DARS consumer for whom the product was originally purchased). Preventive maintenance
must be provided at no additional cost to DARS within three days of notification by DARS, at the consumer's residence or other address specified by
- provide DARS written notice of all goods or equipment purchased with DARS funds that
is subsequently returned to, exchanged, or replaced by the contractor. This notice
must include a description of the item, the current condition of the item returned, the date returned, and the amount of credit due DARS. Furthermore, the contractor
must, by the 15th of each month, remit to DARS a check in the amount of the total "credits" accumulated during the prior calendar month, with supporting documentation and/or credit invoices for each credit reimbursed.
10.3 Documentation and Fees
Contractors agree to provide durable medical equipment at the established
discount of 18 percent from manufacturer's suggested retail price for the
entire functional unit.
Payment for each standard item invoiced must be based on the established
discount of 18 percent from manufacturer's suggested retail price for that
Payment for fabricated goods invoiced
must be based on the vendor-provided specification approved by the DARS
counselor. This includes payment for development of schematics, drawings, or
other required descriptive material; installation; setup and training;
written instructions on use and maintenance; and availability of self-repair
information, parts, warranty, and postwarranty repair.
The DARS counselor is authorized to pay the provider for the entire
functional unit upon receipt of an invoice. The invoice must include the current MSRP amount and discount rate for
the item purchased. A copy of the
manufacturer's price list or order form must be attached to the invoice.
A DARS staff member
- verifies with the consumer that the goods or services were provided,
- documents in the DARS case file that the goods and services were
provided before payment.