California Legislature—2013–14 Regular Session

Assembly Bill No. 582

Introduced by Assembly Member Chesbro

February 20, 2013

An act to amend Section 14105.485 of the Welfare and Institutions Code, relating to Medi-Cal.

LEGISLATIVE COUNSEL’S DIGEST

AB 582, as introduced, Chesbro. Medi-Cal: custom rehabilitation technology services.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law requires the department to establish a list of covered services and maximum allowable reimbursement rates for durable medical equipment and requires the list to be published in provider manuals.

This bill would require the department, for purposes of establishing reimbursement rates, to recognize custom rehabilitation technology services, as defined, as a separate benefit.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

SECTION 1.  

Section 14105.485 of the Welfare and Institutions
Code is amended to read:

14105.485.  

(a) Commencing July 1, 2006, any provider of
custom rehabilitation equipment and custom rehabilitation
technology services to a Medi-Cal beneficiary shall have on staff,
either as an employee or independent contractor, or have a
contractual relationship with, a qualified rehabilitation professional
who was directly involved in determining the specific custom
rehabilitation equipment needs of the patient and was directly
involved with, or closely supervised, the final fitting and delivery
of the custom rehabilitation equipment.

(b) Commencing January 1, 2006, a medical provider shall
conduct a physical examination of an individual before prescribing
a motorized wheelchair or scooter for a Medi-Cal beneficiary. The
medical provider shall complete a certificate of medical necessity,
developed by the department, that documents the medical condition
that necessitates the motorized wheelchair or scooter, and verifies
that the patient is capable of using the wheelchair or scooter safely.

(c) For purposes of this section, the following definitions apply:

(1) “Custom rehabilitation equipment” means any item, piece
of equipment, or product system, whether modified or customized,
that is used to increase, maintain, or improve functional capabilities
with respect to mobility and reduce anatomical degradation and
complications of individuals with disabilities. Custom rehabilitation
equipment includes, but is not limited to, nonstandard manual
wheelchairs, power wheelchairs and seating systems, power
scooters that are specially configured, ordered, and measured based
on patient height, weight, and disability, specialized wheelchair
electronics and cushions, custom bath equipment, standers, gait
trainers, and specialized strollers.

(2) “Custom rehabilitation technology services” means the
application of enabling technology systems designed and assembled
to meet the needs of a specific person experiencing any permanent
or long-term loss or abnormality of physical or anatomical structure
or function with respect to mobility. These services include, but
are not limited to, the evaluation of the needs of a patient with a
disability, including an assessment of the patient for the purpose
of ensuring that the proposed equipment is appropriate, the
documentation of medical necessity, the selection, fit,
customization, maintenance, assembly, repair, replacement, pick
up and delivery, and testing of equipment and parts, and the
training of an assistant caregiver and of a patient who will use the
equipment or individuals who will assist the client in using the
equipment.

(3) “Qualified rehabilitation professional” means an individual
to whom any one of the following applies:

(A) The individual is a physical therapist licensed pursuant to
the Business and Professions Code, occupational therapist licensed
pursuant to the Business and Professions Code, or other qualified
health care professional approved by the department.

(B) The individual is a registered member in good standing of
the National Registry of Rehabilitation Technology Suppliers
(NRRTS), or other credentialing organization recognized by the
department.

(C) The individual has successfully passed one of the following
credentialing examinations administered by the Rehabilitation
Engineering and Assistive Technology Society of North America
(RESNA):

(i) The Assistive Technology Supplier examination.

(ii) The Assistive Technology Practitioner examination.

(iii) The Rehabilitation Engineering Technologist examination.

begin insert

(d) Notwithstanding Section 14105.48 or any other law, and
for purposes of establishing reimbursement rates, the department
shall recognize custom rehabilitation technology services, as
defined in paragraph (2) of subdivision (c), as a separate benefit.

end insert