Letter to Medicaid Director about home health aides & DME
Attached is a letter from legal advocates to Medicaid director identifying several ways that current MassHealth regulations and policies on home health aide services and durable medical equipment (DME) are out of compliance with federal Medicaid regulations and harming our clients. We outline the legal issues, the harm and ask for the agency to take corrective action.
If advocates have clients with home health aide services denied or reduced based on lack of a skilled need or DME denied based on a Medicare coverage determination, please communicate with Vicky Pulos firstname.lastname@example.org. If MassHealth members have these problems, please use Find Legal Aid to find legal represenation near you.
UPDATE: An attached October 2018 DME provider bulletin clarifies that DME suitable for use in the home includes community settings as defined in federal Medicaid regulations and that DME that would not be covered under a Medicare LCD requires an individualized assessment under the MassHealth medical necessity definition.