In response to the Governor’s recent proclamation of a statewide state of emergency due to the risk of wildfires, the Department of Health Care Services (DHCS) recognizes the need to dispense Durable Medical Equipment (DME) and medical supplies to recipients impacted by these fires.
For Medi-Cal fee-for-service recipients displaced or impacted by the fires, providers are instructed to submit a Treatment Authorization Request (TAR) using the statement “Patient impacted by [identify specific county] county fire” within the Miscellaneous Information field on the TAR for DME or medical supplies for those situations requiring a TAR.
DME and medical supply providers are encouraged to provide the requested equipment or supplies immediately or, for items not in stock, as soon as possible, if the need to dispense DME or medical supplies is related to the recipient’s displacement, and not have the recipient return after receiving TAR approval.
For more information about program coverage in an emergency, providers may review the statutes mentioned below.
References to this requirement may be found in the following federal and state laws:
- Social Security Act, Section 1927(d)(5)
- California Welfare and Institutions (W&I) Code, Section 14133.37
- California W&I Code, Section 14185
Emergency services are defined in California Code of Regulations, Title 22, Section 51056. For the purpose of providing treatment of an emergency medical condition, “emergency medical condition” means a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following conditions:
- Placing the patient’s health in serious jeopardy
- Serious impairment to bodily functions
- Serious dysfunction of any bodily organ or part
Providers are encouraged to monitor the Medi-Cal website for future updates. Questions regarding this notice may be directed to the Telephone Service Center (TSC) at 1-800-541-5555, 8 a.m. to 5 p.m Monday through Friday, except national holidays.