​Durable Medical Equipment (DME) Prior Authorization (PA) Criteria Sheets Updated​, CR 119839

Oct 20, 2023

Aligning with the adoption of the MBM, Chapter II, Section 60, Medical Supplies and DME rule, the Office of MaineCare Services (OMS) will be updating the criteria sheets used when submitting a request for PA. The criteria sheets will be located on the HealthPAS portal as of October 31, 2023, using the path MaineCare Information>Manual, Forms, and Criteria Sheets and are as follows:  

New criteria sheets for the following devices: 

• Cochlear Implant Devices 

• Hearing Aids 

• Phototherapy 

• Wheelchair-Manual and Specialty 

Removal of supplemental criteria sheets for the following devices: 

• Augmentative and alternative communication devices 

• CPAP and Bi-PAPs 

• Negative Pressure Wound Therapy 

Revised criteria sheets for the following devices: 

• Apnea Monitor 

• Blood Glucose Monitors and Test Strips 

• Continuous Glucose Monitors 

• Enteral Nutritional Therapy 

• Home Traction 

• Hospital Beds 

• Incontinence Supplies 

• Parenteral Nutritional Therapy 

• Wheelchair – Specialty is now Wheelchair - Manual and Specialty 

• Wheelchair – Power is now Power Mobility Devices 

If you have any questions regarding MBM, Chapter II, Section 60 DME, or the changes in criteria sheets as they relate to PAs, please contact your Provider Relations Specialist, Shannon Beggs.