Stakeholders Try to ‘Take Control' of Repair Issues

Published in Complex Rehab on August 10, 2023

HME NewsThis article was originally featured in HME News.

Stakeholders now have four specific asks, including reimbursement reform, for state Medicaid programs and other payers to increase access to repairs for wheelchairs. 

“No. 1, you need to get paid for your travel and for your diagnosis time for repairs,” said Wayne Grau, executive director of NCART, during a recent industry webinar. “When I brought this up in two meetings I had with legislators – when I told them we don’t get paid for travel or diagnosis – they thought I was kidding. One of them laughed. I said, ‘I’m not kidding,’ and he said, ‘Well that’s dumb.’ I was like, ‘Yeah, that’s what we’re saying.’” 

Stakeholders have ramped up efforts to address issues with repairs in the wake of right-to-repair bills popping up in states across the country, led by Colorado

Also, stakeholders are advocating for eliminating prior authorization and prescription requirements for repairs – “You guys should be able to go out there and fix that product the day you get the call,” Grau said – and reimbursing for preventative maintenance. The latter is the focus of a bill currently working its way through the Pennsylvania state legislature. 

“I don’t understand why we don’t have preventative maintenance,” he said. “We want to identify issues before they become emergencies.” 

Lastly, stakeholders are advocating for requiring providers to “service what they sell,” Grau said. 

“All you folks out there have made (huge) investments into your business infrastructure, so it’s not fair if a person just decides to sell equipment and then says, ‘No, I don’t do the repair, you need to go to the rehab company down the street,’” he said. “That is wrong.” 

Stakeholders, including regional HME associations, VGM and AAHomecare, are currently advocating for these asks at the same time as they are fighting right-to-repair bills in multiple states, including Tennessee, California, Iowa and Massachusetts. 

“That’s going to be a big focus for 2024 is to get our language in there,” Grau said. “Why is that so important? Because we want to really control how things are being done. We also want to present real reform and solutions to the problem, not something that just looks good on paper.”


TAGS

  1. billing & reimbursement
  2. complex rehab
  3. reimbursement
  4. repairs

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