What's happening
This bill adds Medicaid reimbursement rules for complex rehabilitation technology to ensure access for patients with significant medical needs.
Why it matters
Defines “complex rehabilitation technology” (CRT) and who qualifies as a provider. , ensuring that only suppliers with specialized training, accreditation, and in-state presence can provide these highly customized medical devices to patients with serious physical disabilities.
Requires Medicaid to create and maintain specific reimbursement and billing procedures for CRT. , which is intended to address the higher costs and service needs of patients who rely on individually configured equipment such as custom wheelchairs and adaptive devices.
Mandates regular updates to billing codes and allows for minimum reimbursement benchmarks. , aiming to keep coverage in line with federal Medicare standards and preventing managed care organizations from underfunding CRT services.
Emphasizes patient access and continuity of care. by obligating suppliers to provide clear information on repairs and services, and by requiring professional evaluation and configuration, which could lead to better health and quality-of-life outcomes for patients with complex medical needs.
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Who cares
Headline styles
Cover Custom Rehab Tech
Plain English, a few words. Used as the page title.
Sponsors
Assembly Member · Assembly District 108
3 Co-sponsors
History
- Substituted by S4557B
- Ordered to third reading rules cal.485
- Rules report cal.485
- Reported
- Reported referred to rules
- Print number 6120b
- Amend (t) and recommit to ways and means
- Reported referred to ways and means
- Print number 6120a
- Amend (t) and recommit to health
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Expand Medicaid for Rehab Tech
Vetoed · Sponsor Robert Ortt
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
6120--B
2017-2018 Regular Sessions
IN ASSEMBLY
February 23, 2017
Introduced by M. of A. McDONALD -- read once and referred to the Committee on Health -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- reported and referred to the Committee on Ways and Means -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee
AN ACT to amend the social services law, in relation to Medicaid reimbursement for complex rehabilitation technology for patients with complex medical needs
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. The social services law is amended by adding a new section 367-j to read as follows:
§ 367-j. Complex rehabilitation technology; reimbursement. 1. Definitions. As used in this section:
(a) "Complex needs patient" means a medical assistance enrollee with significant physical or functional impairment resulting from a medical condition or disease including, but not limited to: spinal cord injury, traumatic brain injury, cerebral palsy, muscular dystrophy, spina bifida, osteogenesis imperfecta, arthrogryposis, amyotrophic lateral sclerosis, multiple sclerosis, demyelinating disease, myelopathy, myopathy, progressive muscular atrophy, anterior horn cell disease, post-polio syndrome, cerebellar degeneration, dystonia, huntington's disease, spinocerebellar disease, and certain types of amputation, paralysis or paresis.
(b) "Complex rehabilitation technology" means products classified as durable medical equipment within the medicare program that are individually configured for individuals to meet their specific and unique medical, physical and functional needs and capacities for basic and functional activities of daily living. Such products include, but are not limited to: individually configured manual and power wheelchairs
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04523-05-7
A. 6120--B 2
and accessories, adaptive seating and positioning items and accessories, and other specialized equipment such as standing frames and gait trainers and accessories.
(c) "Individually configured" means a device with a combination of sizes, features, adjustments or modifications that are configured or designed by a qualified complex rehabilitation technology supplier for a specific individual by measuring, fitting, programming, adjusting or adapting the device so that the device is consistent with the individual's medical condition, physical and functional needs and capabilities, body size, period of need and intended use as determined by an assessment or evaluation by a qualified health care professional.
(d) "Qualified complex rehabilitation technology professional" means an individual who is certified as an assistive technology professional by a nationally-recognized rehabilitation engineering and assistive technology society.
(e) "Qualified complex rehabilitation technology supplier" means a company or entity that:
(i) is accredited by a nationally-recognized accrediting organization;
(ii) is an enrolled supplier for durable medical equipment under the federal medicare program and the medical assistance program under this title;
(iii) has at least one qualified complex rehabilitation technology professional available to analyze the needs and capacities of complex needs patients in consultation with a qualified health care professional and participate in the selection of appropriate complex rehabilitation technology and provide training in the proper use of the complex rehabilitation technology;
(iv) requires a qualified complex rehabilitation technology professional be physically present for the evaluation and determination of appropriate complex rehabilitation technology for complex needs patients;
(v) has the capability to provide service and repair by qualified technicians for all complex rehabilitation technology it sells;
(vi) has at least one retail vending location within New York state; and
(vii) provides written information regarding how to receive service and repair of complex rehabilitation technology to the complex needs patient prior to the ordering of such technology.
(f) "Qualified health care professional" means a health care professional licensed or otherwise authorized to practice under title eight of the education law, acting within his or her scope of practice.
2. Reimbursement and billing procedures. (a) The commissioner shall maintain specific reimbursement and billing procedures under this title for complex rehabilitation technology products to ensure that Medicaid payments for such products permit adequate access to such products and services for complex needs patients and take into account the significant resources, infrastructure, and staff needed.
(b) The commissioner shall monitor the addition of new billing codes for complex rehabilitation technology by the medicare program and shall expeditiously incorporate such codes under this subdivision.
(c) Where reimbursement rates for complex rehabilitation technology products provided under section forty-four hundred three-f of the public health law or section three hundred sixty-four-j of this title are determined by a managed care organization, they shall be determined consistent with this subdivision. The commissioner may establish minimum
A. 6120--B 3
benchmark reimbursement rates to be paid by managed care organizations under this paragraph.
§ 2. This act shall take effect on the first of April next succeeding the date on which it shall have become a law.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.