Form B - Application For Reimbursement/direct Payment Of Medical Expenses (Except Drugs Provided By The Hospital Authority) In Accordance With Csb Circular No. 2/2013 Page 10
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Notes on reimbursement arrangement for
Continuous Positive Airway Pressure (CPAP) machines
Under the existing policy, unless the attending Hospital Authority (HA) doctor
has certified that a specific or a more sophisticated model of CPAP machines is required, only
the costs of the basic model of CPAP machines will be reimbursable. We have been advised
by HA that the basic models of CPAP machines will cater for the medical needs of the vast
majority of Obstructive Sleep Apnoea patients. Taking into account the prices of various
basic models of CPAP machines available in the market, reimbursement of the basic model of
a CPAP machine will be subject to a maximum rate of $5,800. The rate will be reviewed
regularly, any updated rate will be promulgated by circular memorandum or memo to bureaux
and departments for general information. The maximum rate is NOT applicable to a case
where the attending HA doctor has certified that a specific or a more sophisticated model of
CPAP machine is required by the civil service eligible person (CSEP) on medical grounds. In
other words, reimbursement of the relevant expenses under such cases will not be subject to the
maximum rate.
2.
We note from information provided by suppliers that CPAP machines generally
have an estimated life cycle of around four years. On this basis, we consider it appropriate
and reasonable to adopt a four-year replacement cycle as a reference in processing
reimbursement applications. CSEPs are advised to take this into account in selecting CPAP
machines and to exercise care in the daily use of the machine to minimise the chance of
premature wear and tear. If a replacement of the old CPAP machine is needed, the CSEP has
to provide a supplier letter certifying that the old CPAP machine is beyond economical repairs.
The reference replacement cycle of four years does NOT prohibit replacement of CPAP
machines within four years if the attending HA doctor has certified that the replacement is
necessary for medical treatment.
3.
CPAP consumables that are certified by the attending HA doctor to be required
on medical grounds are also reimbursable.
Unless the attending doctor has certified that a
specific or a more sophisticated model of CPAP machines is required, only the costs of the
consumables used for the basic model of CPAP machines will be considered for
reimbursement.
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