LRB-5765/1
SWB:ahe
2019 - 2020 LEGISLATURE
February 19, 2020 - Printed by direction of Assembly Chief Clerk.
SB605-engrossed,1,3
1An Act to amend 49.45 (9r) (a) 2.; and
to create 49.45 (9r) (d) of the statutes;
2relating to: reimbursement under the Medical Assistance program for
3complex rehabilitation technology.
Analysis by the Legislative Reference Bureau
Engrossment information:
The text of Engrossed 2019 Senate Bill 605, as passed by the senate on
February 19, 2020, consists of the following documents adopted in the senate on
February 19, 2020: the bill as affected by Senate Amendments 1 and 2. Senate
Amendment 2 deleted the material affected by Senate Amendment 1. Consequently
Senate Amendment 1 is not given effect.
Content of Engrossed 2019 Senate Bill 605:
This bill modifies the definition of complex rehabilitation technology. Under
current law, “complex rehabilitation technology” is defined as items classified within
Medicare as durable medical equipment that 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 that are identified as medically necessary. Under the Medical Assistance
program, an item or service must be “medically necessary” in order to be eligible for
reimbursement. The bill specifically identifies power seat elevation and power
standing components of power wheelchairs as items that are included in the
definition of “complex rehabilitation technology.” Under the engrossed bill, when
reviewing prior authorization requests for complex rehabilitation technology items,
DHS and managed care plans must act within ten working days of receiving
complete, clinically relevant written documentation necessary to make a
determination.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB605-engrossed,2,102
49.45
(9r) (a) 2. “Complex rehabilitation technology" means items classified
3within Medicare as durable medical equipment that are individually configured for
4individuals to meet their specific and unique medical, physical, and functional needs
5and capacities for basic activities of daily living and instrumental activities of daily
6living identified as medically necessary. “Complex rehabilitation technology”
7includes complex rehabilitation manual and power wheelchairs, adaptive seating
8and positioning items, and other specialized equipment such as standing frames and
9gait trainers,
power seat elevation or power standing components of power
10wheelchairs, as well as options and accessories related to any of these items.
SB605-engrossed,2,1512
49.45
(9r) (d) When reviewing prior authorization requests for complex
13rehabilitation technology items, the department and managed care plans shall act
14within 10 working days of receiving complete, clinically relevant written
15documentation necessary to make a determination.
