Alabama 2025 Regular Session

Alabama House Bill HB75 Compare Versions

Only one version of the bill is available at this time.

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1	1	HB75INTRODUCED
2	2	Page 0
3	3	HB75
4	4	ZU3MKRW-1
5	5	By Representative Clarke
6	6	RFD: Health
7	7	First Read: 04-Feb-25
8	8	PFD: 06-Jan-25
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14	14	6 ZU3MKRW-1 11/26/2024 JC (L)lg 2024-2846
15	15	Page 1
16	16	PFD: 06-Jan-25
17	17	SYNOPSIS:
18	18	There are no provisions in existing law
19	19	governing the repair of wheelchairs.
20	20	This bill would impose a duty on wheelchair
21	21	dealers to repair wheelchairs in a timely manner, with
22	22	explicit disciplinary authority given to the Board of
23	23	Home Medical Equipment for repeated failure to do so.
24	24	This bill would require Medicaid to cover the
25	25	cost of a customized wheelchair when medically
26	26	necessary.
27	27	This bill would eliminate any requirement for a
28	28	new prescription or prior authorization for the repair
29	29	of a wheelchair from Medicaid or private health
30	30	insurance when the wheelchair is less than seven years
31	31	old.
32	32	This bill would also require wheelchair dealers
33	33	who contract with Medicaid to submit annual reports to
34	34	the Medicaid Agency concerning wheelchair repairs.
35	35	A BILL
36	36	TO BE ENTITLED
37	37	AN ACT
38	38	Relating to wheelchairs; to add Section 34-14C-3.1 to
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68	68	Relating to wheelchairs; to add Section 34-14C-3.1 to
69	69	the Code of Alabama 1975, and to amend Section 34-14C-6, Code
70	70	of Alabama 1975, to provide the Board of Home Medical
71	71	Equipment with authority to discipline licensees who fail to
72	72	repair wheelchairs in a timely manner; to provide standards
73	73	for timely repair of wheelchairs; to require Medicaid to cover
74	74	the cost of customized wheelchairs when medically necessary;
75	75	to limit the requirement of prior authorization by Medicaid or
76	76	private health insurance for repair of certain wheelchairs;
77	77	and to impose a reporting requirement on Medicaid wheelchair
78	78	contractors.
79	79	BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
80	80	Section 1. Section 34-14C-3.1 is added to the Code of
81	81	Alabama 1975, to read as follows:
82	82	§34-14C-3.1
83	83	(a) For the purposes of this section, the following
84	84	terms have the following meanings:
85	85	(1) AUTHORIZED WHEELCHAIR DEALER. A home medical
86	86	equipment services provider that sells or leases wheelchairs,
87	87	including customized wheelchairs.
88	88	(2) CONSUMER. The individual who uses a wheelchair,
89	89	including a customized wheelchair, in his or her place of
90	90	residence, regardless of whether the purchase or lease of the
91	91	wheelchair is funded in whole or in part by the consumer or by
92	92	private or public health insurance.
93	93	(3) CUSTOMIZED WHEELCHAIR. A medically necessary manual
94	94	or motorized wheelchair that is individually configured for
95	95	the consumer with specialized equipment that requires
96	96	evaluation, configuration, fitting, adjustment, programming,
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126	126	evaluation, configuration, fitting, adjustment, programming,
127	127	and long-term maintenance and repair services.
128	128	(4) TIMELY REPAIR. No later than 10 business days after
129	129	the date of request for repair is received from a consumer,
130	130	unless any of the following apply:
131	131	a. The consumer fails to make the wheelchair available
132	132	for repair.
133	133	b. Prior authorization required from private or public
134	134	health insurance is not received.
135	135	c. Parts necessary for repair of the wheelchair have
136	136	not been received.
137	137	(5) WHEELCHAIR. A manual or motorized wheeled device,
138	138	including a customized wheelchair, that enhances the mobility
139	139	or positioning of a consumer.
140	140	(b)(1) An authorized wheelchair dealer who sells or
141	141	leases a wheelchair, including a customized wheelchair, shall
142	142	make timely repair of the wheelchair.
143	143	(2) Upon request, an authorized wheelchair dealer who
144	144	sells or leases a customized wheelchair shall make timely
145	145	repair of the wheelchair at the consumer's residence if it is
146	146	reasonable under the circumstances.
147	147	(3) An authorized wheelchair dealer shall do all of the
148	148	following:
149	149	a. Maintain and advertise an electronic mail address
150	150	and a phone number so that a consumer may request a repair.
151	151	b. Respond to a request for wheelchair repair no later
152	152	than one business day after the date of the request.
153	153	c. Order parts for a repair no later than three
154	154	business days after assessing the need for the repair or after
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184	184	business days after assessing the need for the repair or after
185	185	receiving prior authorization from private or publicly funded
186	186	health insurance.
187	187	(c)(1) On and after October 1, 2025, the board shall
188	188	conspicuously post on its website an electronic mail address
189	189	and phone number to receive complaints regarding timely repair
190	190	issues.
191	191	(2) Upon receiving a complaint pursuant to this
192	192	section, the board may inspect any authorized wheelchair
193	193	dealer for cause pursuant to Section 34-14C-4.
194	194	Section 2. Section 34-14C-6, Code of Alabama 1975, is
195	195	amended to read as follows:
196	196	"§34-14C-6
197	197	(a) The board may deny, suspend, or revoke a license as
198	198	provided in this section.
199	199	(b) A license may not be denied, suspended, or revoked
200	200	except by majority vote of the board and with prior notice and
201	201	opportunity for hearing in accordance with this chapter and
202	202	the Alabama Administrative Procedure Act.
203	203	(c) The board may institute a hearing for denial,
204	204	suspension, or revocation of a license , or any person may file
205	205	a written complaint with the board seeking the denial,
206	206	suspension, or revocation of an application for licensure or
207	207	license issued by the board or the investigation of any
208	208	unlicensed person or entity providing home medical equipment
209	209	services. The complaint shall be in a form prescribed by the
210	210	board.
211	211	(d) A copy of the charges, including notice of the time
212	212	and place of hearing, shall be served by certified mail,
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242	242	and place of hearing, shall be served by certified mail,
243	243	return receipt requested, at least 21 days before the
244	244	scheduled hearing date to the most recent address of the
245	245	applicant or licensee on file with the board, or to the last
246	246	known address of any unlicensed person or entity providing
247	247	home medical equipment services. If the notice and opportunity
248	248	for hearing is refused or the return receipt has not been
249	249	received by the board within 10 days before the scheduled
250	250	hearing, the applicant, licensee, or unlicensed person or
251	251	entity may be served by mailing the charges and notice by
252	252	first class mail, at least seven days before the hearing date,
253	253	to the most recent address on file with the board, or to the
254	254	last known address of the unlicensed person or entity
255	255	providing home medical equipment services.
256	256	(e) The board may invoke disciplinary action as
257	257	outlined in subsection (f) whenever it is established to the
258	258	satisfaction of the board, after a hearing held in accordance
259	259	with this chapter and the Alabama Administrative Procedure
260	260	Act, that any person is guilty of any of the following acts:
261	261	(1) Violation of this chapter or a rule of the board.
262	262	(2) Making a material misrepresentation in furnishing
263	263	information to the board.
264	264	(3) Making a misrepresentation to obtain licensure or
265	265	to otherwise violate this chapter.
266	266	(4) Conviction of or entry of a plea of guilty or nolo
267	267	contendere to any crime that is a felony under the laws of the
268	268	United States, or any state or territory of the United States,
269	269	or to any crime that is a misdemeanor, if an essential element
270	270	of the crime is dishonesty or is directly related to providing
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300	300	of the crime is dishonesty or is directly related to providing
301	301	home medical equipment services.
302	302	(5) Gross negligence or gross misconduct in providing
303	303	home medical equipment services.
304	304	(6) Aiding, assisting, or willingly permitting another
305	305	person to violate any provision of this chapter or rule of the
306	306	board.
307	307	(7) Failing, within 30 days, to provide information in
308	308	response to a written request of the board.
309	309	(8) Failing to cooperate with an inspection or with an
310	310	investigation conducted by the board.
311	311	(9) Engaging in dishonorable, unethical, or
312	312	unprofessional conduct of a character likely to deceive,
313	313	defraud, or harm the public.
314	314	(10) Denial, revocation, suspension, or restriction of
315	315	a license in another state or jurisdiction to provide home
316	316	medical equipment services for a reason other than failure to
317	317	renew the license.
318	318	(11) Directly or indirectly giving to or receiving from
319	319	any person, partnership, corporation, or other legal entity
320	320	any fee, commission, rebate, or other form of compensation for
321	321	services not actually or personally rendered.
322	322	(12) A finding that a licensee on probationary status
323	323	has violated the terms of the probation.
324	324	(13) Willfully making or filing false records, reports,
325	325	or billings in the course of providing home medical equipment
326	326	services including, but not limited to, false records,
327	327	reports, or billings filed with state or federal agencies or
328	328	departments.
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358	358	departments.
359	359	(14) The use of any words, abbreviations, figures, or
360	360	letters with the intention of indicating practice as a home
361	361	medical equipment services provider without having first
362	362	obtained a license from the board.
363	363	(15) Failure to comply with state or federal laws and
364	364	regulations concerning home medical equipment services
365	365	providers.
366	366	(16) Solicitation of home medical equipment services
367	367	using false or misleading advertising.
368	368	(17) Failure to display a license in accordance with
369	369	this chapter.
370	370	(18) Failure to report a change of name, address,
371	371	control, ownership, or administration to the board within 30
372	372	days after the date of change.
373	373	(19) Repeated failure to make timely repair of a
374	374	wheelchair as provided in Section 34-14C-3.1.
375	375	(f) When the board finds any person guilty of any of
376	376	the grounds set forth in subsection (e), the board may enter
377	377	an order imposing one or more of the following penalties:
378	378	(l) A letter of reprimand.
379	379	(2) Imposition of probation for a period of time and
380	380	subject to such conditions as may be prescribed by the board.
381	381	(3) Denial of an application for an initial or renewal
382	382	license.
383	383	(4) Suspension of a license for a period of time
384	384	established by the board, with or without automatic
385	385	reinstatement.
386	386	(5) Revocation of a license.
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416	416	(5) Revocation of a license.
417	417	(6) Payment of restitution to each consumer negatively
418	418	affected by the prohibited act. Proof of such restitution
419	419	shall be a signed and notarized release executed by the
420	420	consumer or the estate of the consumer.
421	421	(7) Assessment of the costs of the disciplinary
422	422	proceedings.
423	423	(g) Failure to comply with any final order of the board
424	424	is also cause for suspension or revocation of a license. The
425	425	board may suspend or revoke any license which has been issued
426	426	based on false or fraudulent representations.
427	427	(h) The board may informally resolve any alleged
428	428	violation of this chapter or rule of the board by stipulation,
429	429	agreed settlement, or consent order, in lieu of an
430	430	administrative hearing.
431	431	(i) Any entity or person found to be providing home
432	432	medical equipment services without a license as required by
433	433	this chapter shall be subject to an administrative fine of up
434	434	to one thousand dollars ($1,000) per day that services were
435	435	provided without a license. Funds collected pursuant to this
436	436	chapter shall be allocated to the administration of the
437	437	program.
438	438	(j) Any entity or person found to be providing home
439	439	medical equipment services without a license as required by
440	440	this chapter may be administratively enjoined by the board
441	441	from providing services until such time as the entity or
442	442	person complies with this chapter.
443	443	(k) In addition to any other disciplinary action
444	444	authorized by this chapter, the board may levy and collect
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474	474	authorized by this chapter, the board may levy and collect
475	475	administrative fines for violations of this chapter or the
476	476	rules or standards of the board in an amount of up to one
477	477	thousand dollars ($1,000) for each violation.
478	478	(l) Any person or entity violating this chapter, upon
479	479	conviction, shall be guilty of a Class A misdemeanor, and
480	480	subject to fine or imprisonment, or both.
481	481	(m) Any entity or person subject to the penalties
482	482	prescribed by subsections (i) and (j) may pursue an appeal
483	483	through the board according to rules promulgatedadopted by the
484	484	board.
485	485	(n) Any hearings related to matters before the board
486	486	shall be conducted in Montgomery County.
487	487	(o) In addition to any other penalty or disciplinary
488	488	action authorized by this chapter, the board may seek an
489	489	injunction against any person or entity found in violation of
490	490	this chapter. In an action for an injunction, the board may
491	491	demand and recover a civil penalty of fifty dollars ($50) per
492	492	day for each violation, reasonable attorney fees, and court
493	493	costs. No civil penalty shall be awarded to the board if an
494	494	administrative fine is assessed pursuant to subsection (i).
495	495	(p) Upon the revocation or suspension of a license, the
496	496	licensee shall immediately surrender the license to the board,
497	497	and if the licensee fails to do so, the board may seize the
498	498	license.
499	499	(q) Any person aggrieved by an adverse action of the
500	500	board may appeal the action to the Circuit Court of Montgomery
501	501	County in accordance with the Alabama Administrative Procedure
502	502	Act."
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532	532	Act."
533	533	Section 3. (a) As used in this section, the following
534	534	words have the following meanings:
535	535	(1) AGENCY. The Alabama Medicaid Agency.
536	536	(2) AUTHORIZED WHEELCHAIR DEALER. As defined in Section
537	537	34-14C-3.1, Code of Alabama 1975.
538	538	(3) COMMISSIONER. The Commissioner of the Alabama
539	539	Medicaid Agency.
540	540	(4) CUSTOMIZED WHEELCHAIR. As defined in Section
541	541	34-14C-3.1, Code of Alabama 1975, for a Medicaid recipient
542	542	with a disability who is unable to achieve maximum mobility
543	543	with a standard wheelchair.
544	544	(5) TIMELY REPAIR. As defined in Section 34-14C-3.1,
545	545	Code of Alabama 1975.
546	546	(6) WHEELCHAIR. As defined in Section 34-14C-3.1, Code
547	547	of Alabama 1975.
548	548	(b) A customized wheelchair shall be covered under
549	549	Medicaid only if it is medically necessary, and a standard
550	550	wheelchair does not meet the recipient's needs as determined
551	551	by the agency.
552	552	(c) The commissioner shall not require a new
553	553	prescription or prior authorization for the medically
554	554	necessary repair of a customized wheelchair unless the
555	555	original prescription or authorization for the customized
556	556	wheelchair is more than: (i) five years old in the case of a
557	557	Medicaid recipient who is under 21 years of age; or (ii) seven
558	558	years old in the case of a Medicaid recipient who is 21 years
559	559	of age or older.
560	560	(d) No later than September 30, 2026, and annually
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590	590	(d) No later than September 30, 2026, and annually
591	591	thereafter, an authorized wheelchair dealer that contracts
592	592	with the agency to sell or lease wheelchairs to Medicaid
593	593	recipients shall submit a report concerning timely repair to
594	594	the commissioner that includes for each repair request all of
595	595	the following information:
596	596	(1) The number of days to initially respond to the
597	597	request.
598	598	(2) The number of days to conduct a repair assessment.
599	599	(3) Whether the repair assessment was made at the
600	600	recipient's residence, the repair facility, remotely, or
601	601	another location.
602	602	(4) If prior authorization to make the repair was
603	603	necessary, the number of days to receive the agency
604	604	determination.
605	605	(5) The number of days from the repair assessment to
606	606	order a replacement part.
607	607	(6) The number of days from the repair assessment to
608	608	complete repair of the wheelchair, including the number of
609	609	days to receive any replacement part ordered.
610	610	(7) Whether the repair was completed at the recipient's
611	611	residence, the repair facility, or another location.
612	612	(e) The commissioner shall seek any federal approval
613	613	necessary, including amendment of the state Medicaid plan or
614	614	application for a waiver, to implement this section.
615	615	(f) The commissioner shall adopt any rules or forms to
616	616	implement this section.
617	617	Section 4. (a) As used in this section, the following
618	618	words have the following meanings:
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648	648	words have the following meanings:
649	649	(1) CUSTOMIZED WHEELCHAIR. As defined in Section
650	650	34-14C-3.1, Code of Alabama 1975.
651	651	(2) HEALTH BENEFIT PLAN. a. Any plan, policy, or
652	652	contract issued, delivered, or renewed in this state that
653	653	provides health coverage that includes payment for
654	654	hospitalization, physician care, treatment, surgery, therapy,
655	655	drugs, equipment, and any other medical expense, regardless of
656	656	the following:
657	657	1. Whether the plan, policy, or contract is provided by
658	658	a health care insurer, health maintenance organization
659	659	established under Chapter 21A of Title 27, Code of Alabama
660	660	1975, health care services plan established under Chapter 20
661	661	of Title 10A, Code of Alabama 1975, or any other entity that
662	662	pays for, purchases, or reimburses for health care services.
663	663	2. Whether the plan is for a group or an individual.
664	664	b. The term does not include accident-only, specified
665	665	disease, individual hospital indemnity, credit, dental-only,
666	666	Medicare supplement, long-term care, disability income, or
667	667	other limited benefit health insurance policies, or coverage
668	668	issued as supplemental to liability insurance, workers'
669	669	compensation, or automobile medical payment insurance.
670	670	(b) Every health benefit plan issued, delivered, or
671	671	renewed on and after January 1, 2026, may not require a new
672	672	prescription or prior authorization for the medically
673	673	necessary repair or replacement of a customized wheelchair
674	674	unless the original prescription is more than five years old.
675	675	Section 5. This act shall become effective on October
676	676	1, 2025.
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686	686	318
687	687	319
688	688	320
689	689	321
690	690	322
691	691	323
692	692	324
693	693	325
694	694	326
695	695	327
696	696	328
697	697	329
698	698	330
699	699	331
700	700	332
701	701	333
702	702	334
703	703	335
704	704	336