About the DMEPOS Program
What are the types of DMEPOS available?
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Durable Medical Equipment (DME) are those items that are Food and Drug Administration (FDA) approved, can stand repeated use, are primarily and customarily used to serve a medical purpose, are not useful to a person in the absence of illness or injury and can be used in the beneficiary's home (e.g. hospital beds, wheelchairs, ect.)
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Medical supplies are those items that are required for medical management of the beneficiary, are disposable or have limited life expectancy, and can be used in the beneficiary's home (e.g. hypodermic syringes/needs, ostomy supplies, ect.)
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Orthotics assist in correcting or strengthening a congenital or acquired physical anomaly or malfunctioning portion of the body.
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Prosthetics artificially replace a portion of the body to prevent or correct physical anomaly or malfunctioning portion of the body.
1
LBJ or DOH referring physician determines the need for a DME and issues a prescription to the patient.
2
Patient takes the prescription to Medicaid to screen for eligibility.
3
Medicaid issues approval by providing a Prior Authorization (PA) and notifies the patient and the DME provider of the approval.
4
The DME Provider gives Medicaid the invoice for the DME and notifies the patient to schedule delivery of the DME.
5
The DME Provider notifies Medicaid of the date of the delivery.
6
Medicaid representative and the DME Provider deliver the DME to the patient. Medicaid conducts a visual audit to confirm accurate DME and that it was delivered to the intended patient.
THE PROCESS FOR THE
DMEPOS PROGRAM
Who Is Eligible?
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US Nationals
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US Citizens
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Lawfully present Non-US National/Citizen under 21
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Must be currently legally residing in American Samoa
What are the required documents?
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Passport and/or Government I.D
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Immunization Records
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Birth Cirtificate
*Any other documents required from Medicaid.