Why the Right to Repair is NOT the Right Thing to Do to Address Delays in Wheelchair Repairs

Published in Complex Rehab on May 20, 2022

Right to RepairRight to Repair legislation has popped up in several states and is a topic that impacts all U.S. Rehab members. If passed, the legislation would allow consumers or patients to be able to repair their own devices. The legislation originally stemmed from other industries where if passed, consumers would have 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 patients attempting to repair their own medical equipment. Hospitals also advocated for this legislation so they could repair their own medical equipment and not need a medical equipment supplier to repair their equipment.

The other major factor with this legislation is patients indicating that they are having difficulty getting their equipment repaired timely. In some cases, patients report that they wait 2-3 months to get repairs. This is especially concerning for patients who use wheelchairs, since the wheelchair is their means of mobility.

If a patient repairs their own equipment and it is not done properly, it could lead to safety issues, warranty issues, insurance issues, and more.

Some insurances do require that providers repair equipment that you sell, but some insurance companies do not have this requirement. U.S. Rehab wants our members to service what you sell. It is also good customer service to offer servicing and repairs on the products that you sell, especially considering the complexity of the medical device. It’s valued, encouraged, and is the right thing to do.

Some patients do feel that they could repair their own equipment; however, there’s no good way to verify that a person can repair equipment without a competency exam. If repairs aren’t done by a competent technician, it could result in equipment damage, property damage, personal injury or in some cases, a fatality.

Medicare and other insurances recognize the importance of a factory-trained, certified technician, and they reimburse for the service or skill of a technician. They use specific language in the DMEPOS Quality Standards that suppliers employ factory-trained technicians. If it wasn’t a requirement to have someone trained to complete this type of labor, they would not pay for it but they do

Those who are pushing for the Right to Repair legislation may not understand that Medicare specifically pays for labor and requires that factory-trained technicians complete repairs. This specific point is where we need to help educate those who are advocating for this understand the ramifications of the legislation, especially when it comes to CRT and DMEPOS Quality Standards.

The competency exam and training are offered through DMERT, which is a collaboration between all major manufacturers. For more information on the DMERT Group, click here.

State Bills

Colorado, Massachusetts, and Pennsylvania all have legislation that relates to the Right to Repair issue.

  • In Colorado, Medicaid Repair Reform and Right to Repair legislation were introduced and opposed by NCART, U.S. Rehab, and other stakeholders. The groups testified virtually and in-person at several committee hearings for both bills. Both bills passed floor votes in the House and Senate. The Medicaid Repair Reform bill was amended to remove the problematic fee language. The Right to Repair legislation was amended with delayed implementation dates and a wavier of liability language before passage. We are working with Colorado legislators to educate them on how these bills will impact patients and providers.
  • In Massachusetts, the Wheelchair Warranty Protection bill was introduced that includes problematic language and changes. NCART, HOMES, AAHomecare, VGM, and U.S. Rehab have worked with legislative champions. We have held several meetings with state disability groups who are in support of the bill in an effort to reach an agreement on amended bill language. Discussions with legislators are ongoing.
  • In Pennsylvania, HB 2522, the Wheelchair Quality Assurance Act, was recently introduced in the state legislature and is still under development. The bill requires certain health insurance plans to cover semi-annual wheelchair preventative maintenance visits. We are working with stakeholders to determine the course of this legislation.

Even if this legislation has not been introduced in your state, we are seeing this language being pushed and is gaining momentum. We do know that patients are having issues with repairs due to the pandemic and supply chain issues. We need to look at why the delays for repairs are happening and educate the advocacy groups because we are all on the same team; we all want what’s best for the patient.

Five Main Reasons for Delays in Repairs and Solutions

There are five main reasons that are contributing to delays in wheelchair repairs and other equipment. The proposed bills described above will not address these issues. For each of these five reasons, we have solutions that could help reduce the time for repairs.

  • Prior Authorization: Insurances other than Medicare do not require prior authorization for wheelchair repairs. When a provider has to submit for prior auth, it causes delays in repairs.
    • Solution: Instead of requiring prior auth, we want to request health insurance to either eliminate or expedite prior auth for repairs, making this process take days, not weeks.
  • Continued Medical Need: Most insurances require continued need, which is required 12 months preceding the date of the repair and must be documented in the patient’s chart in the progress note. The supplier can’t repair the wheelchair until they have continued need, which may cause a delay in repairs.
    • Solution: We would like to request that the health insurance NOT require continued need for patients with a Group 3 condition, such as a neurological condition, myopathy, or congenital skeletal deformity, and/or allow an order to suffice as continued need.
  • Reimbursement Rates: Reimbursement rates have been reduced over the past several years due to Medicare Competitive Bidding Program, which has negatively impacted the reimbursement for repairs. Most private payers also follow Medicare reimbursement rates or structure their contracts as a percentage of Medicare rates. Most suppliers lose money on repairs.
    • Solution: Advocate to congressional representatives, Medicare, and private payers who follow Medicare to roll back the reimbursement rate cuts of 40% from 2016, which would enable wheelchair suppliers the ability to repair wheelchairs timely and accurately.
  • Selecting the Right Wheelchair Supplier: Some suppliers allocate their resources to favor providing new wheelchairs rather than repairing the wheelchairs that they provide.
    • Solution: Advocate for patients to select a local small to mid-sized wheelchair supplier as they tend to dedicate resources for all around patient care, rather than focusing on just new sales.
  • COVID Pandemic Supply Chain Issues: Recently, there are supply chain issues due to the COVID-19 pandemic.
    • Solution: Select a wheelchair supplier that has a loaner wheelchair or loaning a wheelchair component while waiting for parts. Medicare and those that follow Medicare pay for a one-month rental during a repair and the patient can privately pay for additional months if the repair can’t be done within a month due to a delay in getting the part(s).

U.S. Rehab continues to advocate for patients as well as providers. If you hear of Right to Repair or similar legislation bubbling up in your state, please let us know. Please also know if you have any feedback, as the direction we go primarily comes from feedback from our members, we are here to support U.S. Rehab members in any way we can.

For more information on this topic, visit our Government Relations page on our website.


TAGS

  1. advocacy
  2. complex rehab
  3. legislation
  4. vgm government

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