Bill > SB594

This bill establishes the Complex Wheelchair Quality Assurance Act, which requires health insurance policies and government programs to provide semiannual well-visits and maintenance coverage for complex wheelchairs, which are highly specialized mobility devices customized for individuals with specific medical or functional needs. The bill defines a complex wheelchair as a device that is individually designed, primarily serves a medical purpose, and requires specialized evaluation and configuration. Health insurers and government programs (including Medicaid and the Children's Health Insurance Program) must cover semiannual well-visits, which include physical assessments and adjustments, and must provide annual notification to wheelchair users about this coverage. The Department of Human Services is required to seek federal waivers to implement these provisions for Medicaid-eligible individuals and to establish guidelines for well-visits, including reimbursement methodologies for service providers. Both the Department of Human Services and the Insurance Department are authorized to create rules and regulations to implement the act, with provisions for temporary and permanent regulations. The bill mandates periodic reviews of the reimbursement methodology and establishes enforcement mechanisms through existing complaint and insurance practice procedures. The act will apply to new or renewed health insurance policies within 180 days of its effective date, which is 60 days after passage.

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https://www.legis.state.pa.us/cfdocs/billinfo/bill_history.cfm?syear=2025&sind=0&body=S&type=B&bn=594