| |
|
|
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. |
|
|
|
|
|
* * * * * |