Washington Medicaid Standing Frames

Published in Complex Rehab on June 02, 2020

In December 2019, Washington State Health Care Authority (HCA) changed their coverage policies for standing frames and stated that while they would continue to review and potentially authorize requests for standing frames for pediatric patients, they would no longer be considering or authorizing requests for standing frames for patients above the age of 21. VGM/U.S. Rehab staff worked closely with Pacific Association for Medical Equipment Services (PAMES) and other industry stakeholders to engage with Washington Medicaid regarding this policy change. Collectively, we helped educate them regarding the physiological, mental, social, and other benefits that standing frames can provide to patients of ALL ages. To their credit, HCA listened.

Despite the fact that they had a study conducted on standing frames specifically that concluded there was very low strength of evidence for all outcomes related to the effectiveness, safety, and cost-effectiveness of the use of standing frames, we received communication from Washington Medicaid on May 27 stating, “In response to your feedback, the agency is repealing 182-543-3200. The agency will continue to evaluate requests for standing frames using the process outlined in WAC 182-501-0165, which allows for an individualized medical necessity review. Providers must request prior authorization to complete this.”

This is a perfect example of how we can accomplish great things as an industry. We all play a key role in driving change, and it starts with identifying a shortfall and bringing it to the attention of people that can help bring about the change that is necessary. A special thanks to the provider who did just that, and also to PAMES, NCART, AAHomecare, Washington Medicaid staff, Permobil, and all of the other stakeholders that were involved in making this request for change a reality.


comments powered by Disqus

From Our Experts

U.S. Rehab Tech Training at Heartland Addresses All Levels of Experience thumbnail U.S. Rehab Tech Training at Heartland Addresses All Levels of Experience Complex rehab providers attending VGM's 20th Heartland Conference will have the opportunity to increase their expertise in repairing and programming complex rehab wheelchairs as part of U.S. Rehab's Tech Training. CMS Announces 90-Day Extension For CRT Manual Wheelchair Accessories thumbnail CMS Announces 90-Day Extension For CRT Manual Wheelchair Accessories CMS announced a 90-day extension of the suspension of the application of Medicare Competitive Bidding Program pricing to CRT manual wheelchair accessories. The current policy will stay in place through October 1 and there will not be any payment cuts or claims processing changes. Don't Allow Medicare Advantage Plans and MCOs Take Advantage of YOU! thumbnail Don't Allow Medicare Advantage Plans and MCOs Take Advantage of YOU! The HME supplier has always had challenges in getting paid timely and accurately for the items and services they provide to their customers. This is an assumed cost of doing business but the HME supplier still does this because of the reward of taking care of their customers. But nothing has challenged the supplier as much as when a customer has a Medicare Advantage Plan or an MCO. Right to Repair Legislation: Just Say No thumbnail Right to Repair Legislation: Just Say No Over the past few months there have been several bills introduced at the state level titled "Right to Repair." The purpose of these bills is to give the consumer the right to purchase parts from manufacturers directly in order to repair their own products. This may be fine for some consumer goods, but it could have devastating consequences to consumers attempting to repair their own medical equipment for several reasons. The Q2 Buyer's Guide is Available Now thumbnail The Q2 Buyer's Guide is Available Now VGM & Associates is excited to announce that the second quarter Digital Buyer's Guide has been released. The latest edition can be downloaded now. Complex Rehab Legislative Update thumbnail Complex Rehab Legislative Update Legislation is always a hot topic in CRT and this year is no different. We have 5 major issues that we are working: Stopping June 30 Cuts to CRT Manual Wheelchair Accessories, Establishing Coverage for Power Seat Elevation and Power Standing System, Securing Permanent Remote Service and Telehealth Options for CRT, Establishing a Medicare Separate Benefit Category for CRT, State Medicaid Cuts, and the Right to Repair legislation that is currently being introduced in several states. Telehealth for Complex Rehab Technology: Is It Effective? thumbnail Telehealth for Complex Rehab Technology: Is It Effective? This report analyzes telehealth in the complex rehab technology (CRT) industry. In this report, we define telehealth in the current environment of CRT and how we see it moving forward post-pandemic. Then, we will summarize our feelings of how we see the industry moving forward and utilizing the tools that are available to better the industry and patient care. We also have a list of studies on this subject provided at the end of this report. U.S. Rehab Releases Whitepaper on Telehealth in CRT thumbnail U.S. Rehab Releases Whitepaper on Telehealth in CRT U.S. Rehab has released a whitepaper on the use of telehealth in the CRT industry, “Telehealth for Complex Rehab Technology: Is It Effective?”