Washington Medicaid Standing Frames
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.