Attleboro Area Medical Equipment Company
Massachusetts Prior Authorization
Requirements

MASS HEALTH (Medicaid) PA REQUIREMENTS

Prior authorizations take approximately 30 days to process after AA Medical Equipment Company has received the following items:

1.) Prescription
2.) Letter of Medical Necessity
3.) Physical Evaluation (for lightweight or heavy duty
     wheelchairs and hospital beds)

Prescription for Diapers or Disposable Underpads

  • The product needed (adult diapers or disposable underpads)

  • "Two diagnosis needed" First diagnosis must be urinary incontinence due to... (second diagnosis)

  • The amount needed of each product per day

  • Diaper size

  • Refill quantity of one year (PA’s are done on a yearly basis and must be renewed every year.)

Letter of Medical Necessity for Diapers or Disposable Underpads

  • Must be written on physician’s letterhead

  • Has to state the medical reason as to why this person needs the product requested, including all applicable diagnoses

  • Urinary incontinence must be a primary diagnosis

  • Must be “urinary incontinence due to…”

  • State the amount needed of each item on a daily basis for an entire year

  • Physicians signature (Mass Health does not accept a physicians stamped signature)

Prescription for Hospital Beds and Lightweight or Heavy Duty Wheelchairs

  • Diagnosis

Letter of Medical Necessity for Wheelchairs and Hospital Beds

  • Must be written on physician’s letterhead

  • Has to state the medical reason as to why this person needs the equipment requested, including all applicable diagnoses

  • Must list how long the wheelchair or hospital bed is expected to be used

  • Physician’s signature (Mass Health does not accept a physicians stamped signature)

Physical Therapy Evaluation for Wheelchairs and Hospital Beds

  • Must detail why this person needs equipment requested

  • Must list all accessories requested (i.e. elevating leg rests, removable arms, full electric bed, etc.) and why this person needs those accessories

  • Must list how long the wheelchair or hospital bed is expected to be used

For additional information, please call (508) 222-9146