State of Washington | 63rd Legislature | 2013 Regular Session |
READ FIRST TIME 03/01/13.
AN ACT Relating to complex rehabilitation technology products; adding a new section to chapter 74.09 RCW; creating a new section; and providing an effective date.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION. Sec. 1 The legislature intends to:
(1) Protect access for complex needs patients to important
technology and supporting services;
(2) Establish and improve safeguards relating to the delivery and
provision of medically necessary complex rehabilitation technology; and
(3) Provide supports for complex needs patients to stay in the home
or community setting, prevent institutionalization, and prevent
hospitalizations and other costly secondary complications.
NEW SECTION. Sec. 2 A new section is added to chapter 74.09 RCW
to read as follows:
(1) The authority shall establish a separate recognition for
individually configured, complex rehabilitation technology products and
services for complex needs patients with the medical assistance
program. This separate recognition shall:
(a) Establish a budget and services category separate from other
categories, such as durable medical equipment and supplies;
(b) Take into consideration the customized nature of complex
rehabilitation technology and the broad range of services necessary to
meet the unique medical and functional needs of people with complex
medical needs; and
(c) Establish standards for the purchase of complex rehabilitation
technology exclusively from qualified complex rehabilitation technology
suppliers.
(2) The authority shall require complex needs patients receiving
complex rehabilitation technology to be evaluated by:
(a) A licensed health care provider who performs specialty
evaluations within his or her scope of practice, including a physical
therapist licensed under chapter 18.74 RCW and an occupational
therapist licensed under chapter 18.59 RCW, and has no financial
relationship with the qualified complex rehabilitation technology
supplier; and
(b) A qualified complex rehabilitation technology professional, as
identified in subsection (3)(d)(iii) of this section.
(3) As used in this section:
(a) "Complex needs patient" means an individual with a diagnosis or
medical condition that results in significant physical or functional
needs and capacities. "Complex needs patient" does not negate the
requirement that an individual meet medical necessity requirements
under authority rules to qualify for receiving a complex rehabilitation
product.
(b)(i) "Complex rehabilitation technology" means wheelchairs and
seating systems classified as durable medical equipment within the
medicare program as of January 1, 2013, that:
(A) Are individually configured for individuals to meet their
specific and unique medical, physical, and functional needs and
capacities for basic activities of daily living and instrumental
activities of daily living identified as medically necessary to prevent
hospitalization or institutionalization of a complex needs patient;
(B) Are primarily used to serve a medical purpose and generally not
useful to a person in the absence of an illness or injury; and
(C) Require certain services to allow for appropriate design,
configuration, and use of such item, including patient evaluation and
equipment fitting and configuration.
(ii) "Complex rehabilitation technology" includes highly
configurable manual wheelchairs, complex rehabilitation power
wheelchairs, adaptive seating and positioning systems, and other
specialized equipment such as standing frames and gait trainers.
(c) "Individually configured" means a device has a combination of
features, adjustments, or modifications specific to a complex needs
patient that a qualified complex rehabilitation technology supplier
provides by measuring, fitting, programming, adjusting, or adapting the
device as appropriate so that the device is consistent with an
assessment or evaluation of the complex needs patient by a health care
professional and consistent with the complex needs patient's medical
condition, physical and functional needs and capacities, body size,
period of need, and intended use.
(d) "Qualified complex rehabilitation technology supplier" means a
company or entity that:
(i) Is accredited by a recognized accrediting organization as a
supplier of complex rehabilitation technology;
(ii) Meets the supplier and quality standards established for
durable medical equipment suppliers under the medicare program;
(iii) For each site that it operates, employs at least one complex
rehabilitation technology professional, who has been certified by the
rehabilitation engineering and assistive technology society of North
America as an assistive technology professional, to analyze the needs
and capacities of complex needs patients, assist in selecting
appropriate covered complex rehabilitation technology items for such
needs and capacities, and provide training in the use of the selected
covered complex rehabilitation technology items;
(iv) Has the complex rehabilitation technology professional
physically present for the evaluation and determination of the
appropriate individually configured complex rehabilitation technologies
for the complex needs patient;
(v) Provides service and repairs by qualified technicians for all
complex rehabilitation technology products it sells; and
(vi) Provides written information to the complex needs patient at
the time of delivery about how the individual may receive service and
repair.
NEW SECTION. Sec. 3 This act takes effect January 1, 2014.