BOSTON, Massachusetts—Rep. Ayanna Presley of Massachusetts introduced the Facilitating Access to Service and Timely Repairs for Wheelchairs Act. The legislation is designed toward changing how Medicare Advantage plans handle repairs for certain wheelchairs and related equipment.
For complex rehabilitation technology (CRT)—which includes certain power wheelchairs, manual wheelchairs and related accessories—the bill would potentially stop Medicare Advantage plans from requiring:
- Prior authorization before a repair can be covered
- A prescription specifically for the repair
- Extra medical documentation just to approve the repair
The legislation is currently backed by 13 cosponsors and was introduced by Reps. Doris Matsui, Jan Schakowsky and Debbie Dingell. All woman serve on the chair board for the Task Force on Aging and Families.
“No one should have their day derailed because a needed wheelchair repair is stuck in an insurance approval process,” said Matsui. “When a wheelchair breaks, it can result in a loss of independence that should never be subject to unnecessary red tape. As co-chair of the Task Force on Aging and Families, I am proud to co-lead the FAST Repairs for Wheelchairs Act to bring Medicare Advantage in line with traditional Medicare so that people can get timely repairs with the dignity and urgency they deserve.”
The new rule would apply to plan years starting on or after Jan. 1, 2027 following enactment—meaning the change would not take effect immediately, but beginning with the next plan year after the bill becomes law.
The bill said Medicare Advantage plans could still use prior authorization for the initial evaluation of whether the wheelchair or related equipment is medically necessary, and replacement of the equipment if it is lost, permanently damaged, reaches its reasonable useful lifetime or has been in use for five years .
The bill defines CRT to include:
- Certain complex rehabilitative power wheelchairs
- Certain complex rehabilitative manual wheelchairs
- Certain other manual wheelchairs
- Related accessories used with those devices
In practical terms, the bill is meant to make it easier and faster for people enrolled in Medicare Advantage to get repairs for certain medically necessary wheelchairs and related equipment, by removing plan-level approval hurdles for those repairs.
For more information on the bill, click here.