By: Zaffirini  S.B. No. 1804
         (In the Senate - Filed March 11, 2009; March 20, 2009, read
  first time and referred to Committee on Health and Human Services;
  May 1, 2009, reported adversely, with favorable Committee
  Substitute by the following vote:  Yeas 9, Nays 0; May 1, 2009, sent
  to printer.)
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 1804 By:  Shapleigh
 
 
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.
 
  * * * * *