D.C. Mun. Regs. tit. 29, § 998
998.1 Medical alert devices and services include equipment, systems, and services which enable an individual to secure help in the event of an emergency or are used to provide an individual with reminders of medication or treatment schedules.
998.2 Medical alert devices and services are subject to the relevant authorization, delivery, and service requirements for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) set forth in 29 DCMR § 997, except as otherwise set forth in this section.
998.3 Providers of medical alert devices and services shall be enrolled in the District Medicaid program in accordance with the Provider Screening and Enrollment requirements described at 29 DCMR § 9400, except that such providers shall not be required to furnish Medicare-covered items or submit evidence of enrollment in the Medicare program.
998.4 Providers of medical alert devices and services shall comply with the requirements for DMEPOS set forth at 29 DCMR § 996, subject to the following exceptions:
(a) A provider of medical alert devices and services is not required to furnish Medicare-covered items; and
(b) A provider of medical alert devices and services is not required to submit any evidence of enrollment in the Medicare program.
998.5 Providers enrolling as medical alert devices and services providers shall be required to demonstrate capacity to provide Personal Emergency Response System (PERS) services in accordance with the requirements set forth in § 998.7 as a condition of Medicaid enrollment.
998.6 Medicaid coverage of medical alert devices and services include, but are not limited to, the following:
(a) PERS; and
(b) Medication management devices.
998.7 PERS shall be provided in accordance with the following requirements:
(a) PERS is an electronic system that summons assistance for a beneficiary from a friend, relative, or an emergency services provider (police, fire
department, or ambulance) and shall be available twenty-four (24) hours a day, seven (7) days a week.
(6) Conduct monthly service checks;
(7) Provide documentation of all services provided, beneficiary contacts, equipment and system checks, and equipment servicing;
(2) Permit a health care professional to remotely schedule the beneficiary's prescribed medications;
(3) Notify the beneficiary when the prescribed medications are due to be taken;
(4) Release the prescribed medications to a tray of the delivery unit accessible to the beneficiary on the beneficiary's command; and
(5) Record a history of the event for the health care professional;
(d) Include a remote medication management system composed of one (1) or more of the following: clinical and communications software, a medication delivery unit, and/or medication packaging; and
(e) Provide equipment and supplies used in the administration or monitoring of medication prescribed or ordered for a beneficiary by a qualified District Medicaid provider.
998.11 Medicaid coverage for medication management devices shall be limited to beneficiaries who:
(a) Have one or more prescriptions for medication to be taken on an ongoing basis;
(b) Require assistance with the management or administration of their prescribed medication(s);
(c) Have sufficient physical and cognitive ability to take the medications at the prescribed time once dispensed from the device; and
(d) Are not receiving the necessary medication management assistance from a Personal Care Aide, Adult Day Health Program, informal caregiver, or other in-person service provider.
998.12 Effective October 1, 2020, medical alert devices and service providers shall be reimbursed in accordance with the District of Columbia Medicaid Fee Schedule available online at www.dc-medicaid.com.
998.13 All future updates to the reimbursement rates for medical alert devices and services shall comply with the public notice requirements set forth under § 988.4 of Chapter 9 of Title 29 of the District of Columbia Municipal Regulations and provide notice and an opportunity for meaningful comment.
SOURCE: Final Rulemaking published at 69 DCR 011741 (September 30, 2022).