Bill aims to expand coverage for wheelchair tech
Users more likely covered for standing devices
MADISON - Wheelchair technology would be made more accessible and affordable under a bill that would make the devices easier to cover under health insurance.
The bill would classify wheelchair technology that allows its user to be elevated into a standing position as rehabilitative technology, which would ensure that health insurance companies covering the technology use rates in line with Medicare, thereby regulating the price of the devices.
Rep. Jimmy Anderson, D-Fitchburg, who is sponsoring the legislation, said the bill would make it easier for people who want wheelchair elevation and standing equipment to get them.
“What we want to do is make it easier for people to get access to these unique devices — to help with therapy and to help with rehabilitation — and for them to be able to live their lives to the fullest,” said Anderson, who was paralyzed from the waist down after a drunken driver caused a car crash in 2010 that also claimed the lives of Anderson’s family members.
Anderson said when he first got his wheelchair, his insurance company denied his requests for a power wheelchair because he did not have a good enough “medically necessary” reason.
“The insurer’s definition of what is medically necessary and what your definition could be is sometimes different,” Anderson said.
The elimination of the medical necessity requirement would “loosen up that standard” and make the equipment more likely to be covered with a doctor’s recommendation, he said.
“It puts more power into the hands of the patient to work with their doctors and health care providers to make it easier for them to access these devices if they determine them to be supportive,” Anderson said.
Despite using a wheelchair, Anderson said the legislation would “probably not” benefit him. He said he recently paid out-of-pocket for a new wheelchair with the power technology.
“You get wheelchairs about every decade or so,” he said. “My wheelchair is relatively new, and I can’t think of a situation in which I would be getting a new wheelchair anytime soon. I can’t see it helping me personally.”
Under current law, complex rehabilitation technology is defined within Medicare as medically necessary equipment for an individual’s “unique medical, physical and function needs and capacities for basic activities of daily living.”
The legislation would alter this definition to include items that would prevent the hospitalization of a “complex needs patient,” regardless of whether they are medically necessary under Medicare.
Disability Rights Wisconsin, a nonprofit group that advocates for people with disabilities across the state, said it has helped individuals who need standing technology for their wheelchairs get the required equipment.
Monica Murphy, the group’s managing attorney, said the effort has “often been a fight” because it is “common” for managed care organizations to deny standing wheelchairs as not medically necessary.
“We welcome any changes to the law that make it easier for people with disabilities to have the best mobility available to access the community and live as independently as possible,” Murphy said.