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Medical Supplies, Equipment and Appliances Durable Medical Equipment - MEDICAID - INDIANA (New)
Act
by Aug 1, 2026
Effective date
Aug 26, 2026
Identified
Aug 25, 2026
Summary
Humana Medicaid Indiana has issued a new Durable Medical Equipment (DME) and Medical Supplies, Equipment & Appliances (MSEA) coverage policy effective August 26, 2026. The policy establishes coverage criteria, rent-vs-purchase determination guidelines, repair/replacement rules (5-year useful lifetime), and specific device-level coverage determinations. Multiple specialty devices are explicitly listed as NOT medically necessary (e.g., UpSee Mobility Device, Splashy Bath Seat, Safety Sleep Beds, Snoo Smart Sleep Bassinet, Nonpneumatic Compression Controller), requiring billing teams to deny claims for these items.
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What to do
by Aug 1, 2026 · 6 steps
01Billing team must update claims processing system to recognize new policy HUM-IN-2429-000 and implement automated denials for non-covered DME items listed in policy (UpSee Mobility Device, Splashy Bath Seat, Safety Sleep Beds, Snoo Smart Sleep Bassinet, Nonpneumatic Compression Controller).
02Update prior authorization workflows to require medical necessity documentation for all DME claims, including confirmation that items meet ALL five definitional criteria (can withstand repeated use, not useful without illness/injury, appropriate for home/community use, serves medical purpose vs. comfort, prescribed by healthcare provider).
03Configure system to enforce 5-year replacement limitation and apply rent-vs-purchase logic automatically.
04Educate providers and front-desk staff on new coverage rules.
05Update denial templates to cite policy HUM-IN-2429-000.
06Test system changes before August 26, 2026.
If missed: Failure to implement will result in inappropriate claim payments and potential recoupment by Humana.
Codes mentioned
E1399E0680
Original notice
Medical Supplies, Equipment and Appliances Durable Medical Equipment - MEDICAID - INDIANA (New)
mcp.humana.com · Always check the source before changing claims.
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