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General Assembly Raised Bill No. 7106
January Session, 2025
LCO No. 5461
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
AN ACT CONCERNING RECOMMENDATIONS OF AN ADVISORY
COUNCIL ON WHEELCHAIR REPAIR.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 17b-278i of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective July 1, 2025): 2
(a) As used in this section, (1) "customized wheelchair" means a 3
wheelchair built, designed or outfitted for a Medicaid recipient with a 4
physical disability unable to achieve maximum mobility with a 5
standard wheelchair and includes a complex rehabilitation technology 6
wheelchair, (2) ["authorized wheelchair dealer"] "authorized wheelchair 7
or mobility scooter dealer", "complex rehabilitation technology 8
wheelchair", [and] "mobility scooter", "timely repair" and "emergency 9
repair" have the same meanings as provided in section 42-337, as 10
amended by this act, and (3) "medically necessary" has the same 11
meaning as provided in section 17b-259b. Customized wheelchairs and 12
mobility scooters shall be covered under the Medicaid program only 13
when "medically necessary" and a standard wheelchair or scooter does 14
not meet an individual's needs as determined by the Department of 15
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Social Services. Wheelchair and mobility scooter repairs and parts 16
replacements may be subject to review and approval by the department. 17
Refurbished wheelchairs or mobility scooters, parts and components 18
shall be utilized whenever practicable. The Department of Social 19
Services may designate categories of durable medical equipment in 20
addition to customized wheelchairs and mobility scooters for which 21
reused equipment, parts and components shall be utilized whenever 22
practicable. 23
(b) Notwithstanding the provisions of subsection (a) of this section, 24
[on and after July 1, 2024,] the Commissioner of Social Services shall not 25
require a new prescription or prior authorization for the medically 26
necessary repair of a [customized] wheelchair or mobility scooter unless 27
the original prescription for such wheelchair or mobility scooter is more 28
than five years old. The commissioner shall provide coverage under the 29
medical assistance program for (1) the medically necessary repair or 30
replacement of a Medicaid recipient's wheelchair or mobility scooter, (2) 31
transportation by a Medicaid recipient to a repair facility of an 32
authorized wheelchair or mobility scooter dealer to repair such 33
recipient's customized wheelchair or mobility scooter, (3) annual 34
preventive maintenance of a Medicaid recipient's wheelchair or 35
mobility scooter, and (4) payment for domestic overnight delivery or 36
express international delivery of a wheelchair or mobility scooter part 37
necessary for a repair but not on the premises of the authorized 38
wheelchair or mobility scooter dealer making the repair. 39
(c) The commissioner shall inform Medicaid recipients who use 40
wheelchairs or mobility scooters of their rights to timely and emergency 41
repair pursuant to section 42-338, as amended by this act. The 42
commissioner shall seek any federal approval necessary, including 43
amending the Medicaid state plan or applying for a Medicaid waiver, to 44
implement the provisions of this section. 45
(d) The commissioner, pursuant to section 17b-10, may implement 46
policies and procedures necessary to administer the provisions of this 47
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section while in the process of adopting such policies and procedures as 48
regulations, provided the commissioner posts notice of intent to adopt 49
regulations on the eRegulations System not later than twenty days after 50
the date of implementation. Policies and procedures implemented 51
pursuant to this section shall be valid until the time final regulations are 52
adopted. 53
Sec. 2. Section 38a-492w of the general statutes is repealed and the 54
following is substituted in lieu thereof (Effective January 1, 2026): 55
(a) As used in this section, (1) ["complex rehabilitation technology 56
wheelchair" has] "authorized wheelchair or mobility scooter dealer", 57
"wheelchair" and "mobility scooter" have the same [meaning] meanings 58
as provided in section 42-337, as amended by this act, and (2) "medically 59
necessary" means a written determination by a policy holder's health 60
care provider that repair or replacement of a [complex rehabilitation 61
technology] wheelchair or mobility scooter is necessary to preserve the 62
health of such policy holder. 63
(b) Each individual health insurance policy providing coverage of the 64
types specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-65
469 delivered, issued for delivery, renewed, amended or continued in 66
this state on and after January 1, [2025] 2026, shall not require a new 67
prescription or prior authorization for the medically necessary repair or 68
replacement of a [complex rehabilitation technology] policy holder's 69
wheelchair or mobility scooter unless the original prescription for such 70
wheelchair or mobility scooter is more than five years old. 71
(c) Each individual health insurance policy providing coverage of the 72
types specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-73
469 delivered, issued for delivery, renewed, amended or continued in 74
this state on and after January 1, 2026, shall provide a policy holder 75
coverage for (1) the medically necessary repair or replacement of a 76
wheelchair or mobility scooter, (2) annual preventive maintenance of a 77
wheelchair or mobility scooter, and (3) payment for domestic overnight 78
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delivery or express international delivery of a wheelchair or mobility 79
scooter part necessary for a repair but not on the premises of the 80
authorized wheelchair or mobility scooter dealer making such repair. 81
[(c)] (d) The Insurance Commissioner shall adopt regulations, in 82
accordance with chapter 54, to implement the provisions of this section. 83
Sec. 3. Section 38a-518w of the general statutes is repealed and the 84
following is substituted in lieu thereof (Effective January 1, 2026): 85
(a) As used in this section, (1) ["complex rehabilitation technology 86
wheelchair" has] "authorized wheelchair or mobility scooter dealer", 87
"wheelchair" and "mobility scooter" have the same [meaning] meanings 88
as provided in section 42-337, as amended by this act, and (2) "medically 89
necessary" means a written determination by a policy holder's health 90
care provider that repair or replacement of a [complex rehabilitation 91
technology] wheelchair or mobility scooter is necessary to preserve the 92
health of such policy holder. 93
(b) Each group health insurance policy providing coverage of the 94
types specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-95
469 delivered, issued for delivery, renewed, amended or continued in 96
this state on and after January 1, [2025] 2026, shall not require a new 97
prescription or prior authorization for the medically necessary repair or 98
replacement of a [complex rehabilitation technology] wheelchair or 99
mobility scooter unless the original prescription is more than five years 100
old. 101
(c) Each group health insurance policy providing coverage of the 102
types specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-103
469 delivered, issued for delivery, renewed, amended or continued in 104
this state on and after January 1, 2026, shall provide a policy holder 105
coverage for (1) the medically necessary repair or replacement of a 106
wheelchair or mobility scooter, (2) annual preventive maintenance of a 107
wheelchair or mobility scooter, and (3) payment for domestic overnight 108
delivery or express international delivery of a wheelchair or mobility 109
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scooter part necessary for a repair but not on the premises of the 110
authorized wheelchair or mobility scooter dealer making such repair. 111
[(c)] (d) The Insurance Commissioner shall adopt regulations, in 112
accordance with chapter 54, to implement the provisions of this section. 113
Sec. 4. (NEW) (Effective January 1, 2026) As used in this section, 114
"wheelchair" and "mobility scooter" have the same meanings as 115
provided in section 42-337 of the general statutes, as amended by this 116
act. Except as otherwise required in any collective bargaining 117
agreement, the State Comptroller shall make available to an enrollee of 118
the state employee health plan established pursuant to section 5-259 of 119
the general statutes coverage for medically necessary wheelchairs and 120
mobility scooters and repair of such wheelchairs and mobility scooters 121
consistent with the provisions for such wheelchairs and mobility 122
scooters provided in sections 38a-492w of the general statutes, as 123
amended by this act, and 38a-518w of the general statutes, as amended 124
by this act. 125
Sec. 5. Section 42-337 of the general statutes is repealed and the 126
following is substituted in lieu thereof (Effective July 1, 2025): 127
As used in this section and [section] sections 42-338 and 42-339, as 128
amended by this act: 129
(1) "Authorized wheelchair or mobility scooter dealer" means any 130
company doing business in the state selling or leasing wheelchairs, 131
including complex rehabilitation technology wheelchairs, mobility 132
scooters, or both. 133
(2) "Complex rehabilitation technology" has the same meaning as 134
provided in section 17b-278j. 135
(3) "Complex rehabilitation technology wheelchair" means a 136
specialized, medically necessary manual or powered wheelchair 137
individually configured for the user with specialized equipment that 138
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requires evaluation, configuration, fitting, adjustment, programming 139
and long-term maintenance and repair services. 140
(4) "Consumer" means the purchaser or lessee of a wheelchair, 141
including a complex rehabilitation technology wheelchair, or mobility 142
scooter, irrespective of whether the purchase or lease of the wheelchair 143
or mobility scooter is funded in whole or in part by the consumer or 144
privately or publicly funded health insurance. 145
(5) "Emergency repair" means repair services when a wheelchair or 146
mobility scooter is completely inoperable on weekends and holidays 147
and may include remote repair services if such service renders the 148
wheelchair or mobility scooter operable. 149
(6) "Mobility scooter" means a medically necessary, battery-powered 150
vehicle with a seat, three or four wheels and a stable foot rest prescribed 151
by a licensed health care provider for a person with a physical disability 152
that impairs such person's mobility. 153
(7) "Systemic noncompliance" means the failure by an authorized 154
wheelchair or mobility scooter dealer to meet timely repair 155
requirements for more than five per cent of repair requests in a thirty-156
day period. 157
[(5)] (8) "Timely repair" means as soon as practicable but not later 158
than ten business days after the date of request for repair from a 159
consumer, provided (A) the consumer makes the wheelchair or mobility 160
scooter available, and (B) any prior authorization required from an 161
insurer has been acquired. [, and (C)] The timely repair period shall be 162
tolled by any time spent waiting for prior authorization from an insurer 163
or for delivery of necessary parts ordered for the repair by an authorized 164
wheelchair or mobility scooter dealer. [shall not be included in the ten 165
business days.] 166
[(6)] (9) "Wheelchair" means a manual or motorized wheeled device 167
that enhances the mobility or positioning of an individual with a 168
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disability and includes a complex rehabilitation technology wheelchair. 169
Sec. 6. Section 42-338 of the general statutes is repealed and the 170
following is substituted in lieu thereof (Effective July 1, 2025): 171
(a) An authorized wheelchair or mobility scooter dealer shall timely 172
repair a wheelchair, including a complex rehabilitation technology 173
wheelchair [,] or mobility scooter, sold or leased by such dealer in the 174
state and provide emergency repair when a consumer's wheelchair or 175
mobility scooter is rendered completely inoperable. An authorized 176
wheelchair or mobility scooter dealer who sells or leases a complex 177
rehabilitation technology wheelchair or mobility scooter in the state 178
shall provide timely or emergency repair of such wheelchair or mobility 179
scooter at a consumer's home upon request and, in consultation with the 180
Office of the Healthcare Advocate, shall notify consumers in writing of 181
their rights pursuant to this section at (1) the point and time of sale or 182
lease of such wheelchair or mobility scooter, (2) in an annual mailing, 183
(3) on the Internet web site of such dealer, and (4) in all electronic 184
communications with consumers. 185
(b) An authorized wheelchair or mobility scooter dealer shall 186
maintain an electronic mail address and a phone line for consumer 187
repair requests that are accessible each business day and capable of 188
receiving and recording messages. The authorized wheelchair or 189
mobility scooter dealer shall (1) respond to a request for wheelchair or 190
mobility scooter repair and assess the need for such repair not later than 191
one business day after the date of such request, [and] (2) order parts for 192
a repair not later than three business days after assessing the need for 193
the repair or after receiving prior authorization from an insurer for the 194
repair, and (3) employ sufficient staff and stock sufficient parts to ensure 195
timely repair and emergency repair, if necessary, and a domestic 196
overnight and international express delivery option for parts needed for 197
such repairs but not on the premises of such dealer. An authorized 198
wheelchair or mobility scooter dealer shall utilize a scheduling 199
management system that offers (A) sufficient notice to a consumer of a 200
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repair date and time, (B) follow-up electronic mail messages to a 201
consumer after a repair request with a summary of the request and an 202
estimate of time left before a repair is completed, and (C) a contact 203
number or email address at the authorized dealer to resolve problems 204
with the response to the repair request. An authorized wheelchair or 205
mobility scooter dealer shall provide a written receipt to a consumer 206
upon completion of the repair that records the type of repair, the date 207
the repair was requested and the date the repair was completed. 208
(c) On and after July 1, 2024, the Office of the Healthcare Advocate, 209
in consultation with the Department of Consumer Protection, shall 210
maintain a phone number and electronic mail address to be posted 211
conspicuously on the Internet web sites of the Office of the Healthcare 212
Advocate and the department, to receive and record complaints 213
regarding timely repair issues. Not later than January 1, 2025, and 214
annually thereafter, the Healthcare Advocate shall submit a report to the 215
joint standing committees of the General Assembly having cognizance 216
of matters relating to general law, human services and insurance 217
regarding the complaints received and recorded pursuant to this 218
subsection. The Office of the Healthcare Advocate shall, within 219
available appropriations, conduct a public awareness campaign to 220
inform consumers of their rights concerning timely wheelchair and 221
mobility scooter repair under state law. 222
(d) [Not later than December 31, 2024, and annually thereafter, an] 223
An authorized wheelchair or mobility scooter dealer that contracts with 224
the Department of Social Services to sell or lease wheelchairs or mobility 225
scooters to Medicaid recipients shall submit a monthly report to the 226
Commissioner of Social Services and the advisory council established 227
pursuant to section 42-339, as amended by this act, regarding repair of 228
such wheelchairs or mobility scooters. Not later than August 1, 2025, the 229
advisory council shall approve and disseminate to authorized 230
wheelchair and mobility scooter dealers a uniform definition for the 231
term "wheelchair or mobility scooter repair technician" and 232
qualifications for such technician for use by such dealers in required 233
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reporting. On and after September 1, 2025, any authorized wheelchair 234
or mobility scooter dealer in the state, regardless of whether such dealer 235
contracts with the Department of Social Services to sell or lease 236
wheelchairs or mobility scooters to Medicaid recipients, shall submit a 237
monthly report and an annual report compiling the data of the monthly 238
reports to the commissioner and said council. The [report] reports shall 239
include, but need not be limited to, number, duties and starting and 240
average compensation and benefits of such dealer's staff, including, but 241
not limited to, wheelchair or mobility scooter repair technicians, any 242
data available on national starting and average compensation and 243
benefits for such technicians, new job postings for such technicians and 244
minimum, maximum and average times from the date and time of a 245
repair request for the authorized wheelchair or mobility scooter dealer 246
to: (1) [respond] Respond; (2) conduct a repair assessment (A) in the 247
home or other community location, (B) remotely, or (C) at a repair 248
facility; (3) request any necessary prior authorization from the 249
Department of Social Services or a private insurer and receive a decision 250
from the department or private insurer on such request; (4) order any 251
wheelchair or mobility scooter parts needed; (5) receive delivery of any 252
needed repair parts; and (6) complete repairs (A) in the home or other 253
community location, (B) remotely, or (C) at a repair facility. 254
(e) On and after October 1, 2025, it shall be an unfair or deceptive act 255
or practice pursuant to subsection (a) of section 42-110b for an 256
authorized wheelchair or mobility scooter dealer whose repair record 257
meets the definition of systemic noncompliance provided in section 42-258
337, as amended by this act, to violate the provisions of this section. 259
(f) Nothing in this section shall be construed to limit the rights or 260
remedies of a consumer pursuant to sections 42-330 to 42-334, inclusive. 261
Sec. 7. Subsections (a) and (b) of section 42-339 of the general statutes 262
are repealed and the following is substituted in lieu thereof (Effective July 263
1, 2025): 264
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(a) There is established a [complex rehabilitation technology and] 265
wheelchair and mobility scooter repair advisory council to monitor 266
repairs of wheelchairs, including complex rehabilitation technology 267
wheelchairs, and mobility scooters, as defined in section 42-337, as 268
amended by this act, and to make recommendations concerning 269
improving repair times. 270
(b) The advisory council shall consist of the following members: 271
(1) Two appointed by the House and Senate chairpersons of the joint 272
standing committee of the General Assembly having cognizance of 273
matters relating to human services, one of whom is a consumer who 274
uses a complex rehabilitation technology wheelchair or a mobility 275
scooter purchased, leased or repaired under the Medicaid program, and 276
one of whom is a representative of the state advocacy system for persons 277
with disabilities, established pursuant to section 46a-10b; 278
(2) Two appointed by the House and Senate ranking members of the 279
joint standing committee of the General Assembly having cognizance of 280
matters relating to human services, one of whom is a consumer who 281
uses a [complex rehabilitation technology] wheelchair or a mobility 282
scooter purchased, leased or repaired under a private health insurance 283
policy, and one of whom is an authorized wheelchair or mobility scooter 284
dealer, as defined in section 42-337, as amended by this act; 285
(3) Two appointed by the House and Senate chairpersons of the joint 286
standing committee of the General Assembly having cognizance of 287
matters relating to general law, each of whom is a representative of an 288
organization that represents persons with physical disabilities; 289
(4) Two appointed by the House and Senate ranking members of the 290
joint standing committee of the General Assembly having cognizance of 291
matters relating to general law, each of whom is a consumer who 292
privately pays for [complex rehabilitation technology] wheelchairs or 293
mobility scooters; 294
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(5) The Commissioner of Aging and Disability Services, or the 295
commissioner's designee; 296
(6) The Insurance Commissioner, or the commissioner's designee; 297
(7) The Commissioner of Social Services, or the commissioner's 298
designee; 299
(8) The Healthcare Advocate, or the Healthcare Advocate's designee; 300
and 301
(9) The Commissioner of Consumer Protection, or the commissioner's 302
designee. 303
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2025 17b-278i
Sec. 2 January 1, 2026 38a-492w
Sec. 3 January 1, 2026 38a-518w
Sec. 4 January 1, 2026 New section
Sec. 5 July 1, 2025 42-337
Sec. 6 July 1, 2025 42-338
Sec. 7 July 1, 2025 42-339(a) and (b)
Statement of Purpose:
To implement the recommendations of an advisory council on
wheelchair repair concerning timely repair of wheelchairs and mobility
scooters.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]