Manufacturers and Distributors Application to list new devices for the Assistive Devices Program

Overview

Find the forms required to have a new product listed with the Assistive Devices Program. A new product is a product that is an upgrade to a device, or provides only moderate, little or no clinical or functional advantage over comparable devices in the product manual, but the product remains priced at or below the comparable devices.

(Please refer to section 205 of the Policies and Procedures Manual for the Assistive Devices Program for additional details on listing new products, including new types of products.)

Respiratory devices

• CPAP/APAP/BPAP Product Evaluation

Mobility — wheelchairs, positioning (seating), and ambulation aids

• Device Listing Application Package – Manufacturers/Distributors
• Application for Equipment Listing Wheelchairs, Positioning and Ambulation Aids
• Application for Funding of Changes/Modifications/New Options to ADP Approved Devices
• Statement of Support for Device Listing Wheelchairs, Positioning and Ambulation Aids
• Prior Testing Disclosure — Ambulation Aids
• Prior Testing Disclosure — Manual Wheelchair
• Prior Testing Disclosure — Powered Mobility Devices

Insulin pump and supplies

• Application for Equipment Listing Insulin Pumps and Application for Equipment Listing Insulin Pumps — Checklist
• Insulin Pump Product Evaluation

Pressure modification devices

• Application for Equipment Listing Pressure Modification Devices
• Statement of Support for Device Listing Pressure Modification Devices
• Manufacturer Checklist