Policies and Procedures Manual of the Assistive Devices ...

1 Ministry of Health & Long-Term CarePolicies and Procedures Manual for the Assistive Devices Program Assistive Devices Program Ministry of Health & Long-Term Care May 2016 and Procedures Manual for the Assistive Devices Program 2 May 2016 Table of Amendments The August 2015 edition of the ADP Manual i ncludes a number o f technical correc tions have been made. In a ddition, the following s ubstantive changes have been made: Part 4 Conflict of Interest policy has been revised. Policy 325 added Letters for Insurance Purposes policy. Section Text missing from the September 2012 version has been restored.

2 Section Revised to specify the minimum frequency of authorization in order to maintain Authorizer status. Section Temporary vendor registration numbers are not provided. Policy 900 and section Added policy in relation to operational disruptions. Appendix A Revised documents and information required to apply for registration as a Vendor. Appendix C Revised layout of suggested format for proof of delivery. An alternate fax number f or ADP has been added in five sections. Policies and Procedures Manual for the Assistive Devices Program 3 May 2016 This page will list all substantive changes to this version of the ADP Manual .

3 Section Change Date 415 Added a revised Advertising Policy November 4, 2015 645, 650 Removed the Advertising and Solicitation of Client Business Policies November 4, 2015 Added new example in Conflict of Interest Policy - #6 December 1, 2015 420 Added new Referrals policy December 1, 2015 200 Revised Devices Available for Funding Assistance policy January 15, 2016 425 Replaced Policy 610, Vendors Not Located in Ontario January 22, 2016 600, 601, 602 Revised Policies relating to applying for registration as a new Vendor, applying for registration of an additional Vendor location or category of Devices , and maintaining Vendor status February 16, 2016 405, 615, 620 Revised to reference policy exceptions in the Device-specific Policy and Administration Manuals.

4 May 3, 2016 600, 601, Appendix A Minor updates to wording to reflect current Procedures and references. August 5, 2016 Policies and Procedures Manual for the Assistive Devices Program 4 May 2016 Table of C ontents Table of Amendments .. 2 Table of C ontents .. 4 Part 1: Introduction .. 10100 Purpose of the Manual .. 10105 Overview of the Assistive Devices Program .. 11110 Definitions .. 14 Part 2: Devices .. 19200 Devices Available for Funding Assis tance .. 19205 Listi ng New Products .. 20210 Removal of Listed Devices .. 24215 Device Pricing Reviews.

5 26220 Replacement of Funded Devices .. 26 Part 3: C lients .. 31300 Eligibility C riteria for Program Benefits .. 31305 Funding Available to Clients .. 32310 Funding Available to Clients Receiving Social Assis tance .. 33 Policies and Procedures Manual for the Assistive Devices Program 5 May 2016 315 Payment to Clients .. 34320 Release of Information about Previous Funding .. 35325 Letters for Insuranc e Purposes .. 36 Part 4: General Authorizer and Vendor Polici es .. 39400 Conduct of Authorizers a nd Vendors .. 39405 Conflict of Interest.

6 39410 Claims Verification and Review .. 44415 Advertising .. 47420 Referrals .. 48425 Vendors, Authorizers and Clinics Not Located in Ontario .. 49 Part 5: Authorizers .. 52500 Authorizer Roles a nd Ongoing Responsibilities .. 52505 Becoming Registe red with the Pr ogram .. 52510 Change of Information .. 55515 Vendor Lists Provided to Client by Authorizers .. 56520 Records a nd Review .. 57525 Maintaining Authorizer Status .. 57530 Termination of the Authorizer Agreement .. 58535 Request for Access to the Health Card Validation System .. 59 Part 6: Vendors.

7 62600 Applying for Registration New Vendor .. 62 Policies and Procedures Manual for the Assistive Devices Program 6 May 2016 601 Applying for Registration Additional Vendor Location or Additional Category of Devices .. 65602 Maintaining Registration as a Vendor .. 69605 Manufactu rers a nd Distributors as Vendors .. 70615 Relationshi ps of Hospit als a nd Vendors .. 71620 Vendors Sharing Proceeds with Long- Term Care Homes .. 73625 Removing a Registered Vendor Locati on or a Category of Devices .. 73630 Vendors A pplyi ng f or Another Cate gory.

8 75635 Registrati on in Cases of Assignment or Changes of Control .. 76640 Informing Persons of t he Program .. 78655 Provision of Devices .. 78660 Refusal to S upply for Safety Reasons .. 79665 Warranties of Purchased Devices .. 80670 Repairs of Purchased Devices .. 80675 Bankruptcy .. 81680 Termination of the Vendor Agreement due to an Event of Default .. 82685 Reconciliation Reports .. 82 Part 7: Personal Health Information .. 85700 Protecti on of Personal and Personal Health I nformation .. 85 Part 8: Application Forms .. 88800 Types a nd Content of Application Forms.

9 88 Policies and Procedures Manual for the Assistive Devices Program 7 May 2016 805 Completi ng t he Applicati on 89810 Submitting t he Completed Application Form .. 91815 Application Form 92820 Stale-Dated Assessments and Application Forms .. 92 Part 9: Invoice Processing and Payment .. 95900 General Funding Policy .. 95905 Rebates .. 96910 Returned Devices .. 98915 Invoice Requirements .. 99920 Invoice Submissions .. 102925 Invoice Processing .. 1 03930 Payment to 104935 Client Signature on Invoice .. 106940 Electr onic Funds Transfer (EFT) Accounts.

10 108945 Stale-Dated Invoices .. 108 Part 10: Appeals and Complaints .. 1111000 Appealing a Program Decision .. 1111005 Complaints .. 114 Part 11: Contacts .. 1181100 Program Addresses .. 1181105 Personnel to Contact .. 119 Policies and Procedures Manual for the Assistive Devices Program 8 May 2016 Appendix A: Required Documents and Information .. 121 Appendix B: Proof of Delivery Document .. 122 Appendix C: Proof of Delivery Document .. 123 Policies and Procedures Manual for the Assistive Devices Program 9 May 2016 Introduction 1 Policies and Procedures Manual for the Assistive Devices Program 10 May 2016 Part 1: Introduction 100 Purpose of the Manual The purpose of the Policies and Procedures Manual for the Assistive Devices Program, otherwise known as the ADP Manual , is to present, in one comprehensive document, the Policies and Procedures of the Assistive Devices Program that apply across the Program.