By: Zaffirini S.B. No. 1804
A BILL TO BE ENTITLED
AN ACT
relating to medical assistance reimbursement for wheeled mobility
systems for recipients of medical assistance.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 32, Human Resources Code,
is amended by adding Section 32.0424 to read as follows:
Sec. 32.0424. REIMBURSEMENT FOR WHEELED MOBILITY SYSTEMS.
(a) In this section:
(1) "Qualified rehabilitation professional" means a
person who:
(A) holds a certification as an assistive
technology professional or a rehabilitation engineering
technologist issued by, and is in good standing with, the
Rehabilitation Engineering and Assistive Technology Society of
North America, provided that the requirements for that
certification are at least as stringent as the requirements in
effect on January 1, 2009; or
(B) is otherwise qualified to conduct the
professional activities of a person who holds a certification
described by Paragraph (A), as determined by rules adopted by the
executive commissioner of the Health and Human Services Commission.
(2) "Wheeled mobility system" means an item of durable
medical equipment that is a customized powered or manual mobility
device or a feature or component of the device, including the
following features and components:
(A) seated positioning components;
(B) powered or manual seating options;
(C) specialty driving controls;
(D) multiple adjustment frame;
(E) nonstandard performance options; and
(F) other complex or specialized components.
(b) The department may provide medical assistance
reimbursement for the provision of, or the performance of a major
modification to, a wheeled mobility system only if:
(1) the system is delivered to a recipient by a medical
assistance provider that is, or directly employs, a qualified
rehabilitation professional and that professional was present and
involved in any clinical assessment of the recipient that is
required for obtaining the system; and
(2) at the time the wheeled mobility system is
delivered to the recipient, the qualified rehabilitation
professional:
(A) is present for and directs a fitting to
ensure that the system is appropriate for the recipient; and
(B) verifies that the system functions relative
to the recipient.
(c) The executive commissioner of the Health and Human
Services Commission shall adopt rules specifying:
(1) the scope, including any required components, of
the fitting and verification of functionality required by
Subsection (b);
(2) documentation of the fitting and verification of
functionality that must be submitted as part of a claim for
reimbursement for the provision or modification of a wheeled
mobility system; and
(3) the appropriate reimbursement methodology for
compensating the evaluation and final fitting services provided by
qualified rehabilitation professionals involved in the provision
or modification of wheeled mobility systems.
SECTION 2. Not later than January 1, 2011, the executive
commissioner of the Health and Human Services Commission shall
adopt the rules required by Subsection (c), Section 32.0424, Human
Resources Code, as added by this Act.
SECTION 3. The changes in law made by Section 32.0424, Human
Resources Code, as added by this Act, apply only to a claim for
medical assistance reimbursement made for a wheeled mobility system
that is delivered on or after September 1, 2011. A claim for
medical assistance reimbursement made for a system that is
delivered before that date is governed by the law in effect on the
date the system was delivered, and that law is continued in effect
for that purpose.
SECTION 4. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 5. This Act takes effect September 1, 2009.