Wheelchair repair; establishing time restrictions to ensure prompt repair, to require Medicaid coverage of repair, and to require manufacturers of motorized wheelchairs to provide necessary documentation, parts, and tools to independent repair providers

HB258 INTRODUCED Page 0 HB258 5V1EYMM-1 By Representative Clarke RFD: State Government First Read: 15-Jan-26 1 2 3 4 5 5V1EYMM-1 01/12/2025 JC (L)lg 2025-3503 Page 1 First Read: 15-Jan-26 SYNOPSIS: There are no provisions in existing law governing the repair of customized wheelchairs. This bill would require wheelchair repair providers to make repairs in a timely manner. Repair providers that are also licensed home medical equipment services providers would be subject to discipline by the Board of Home Medical Equipment for repeated failure to make timely repairs. This bill would require Medicaid to cover the cost of a customized wheelchair when medically necessary. This bill would also require wheelchair repair providers that contract with Medicaid to submit annual reports to the Medicaid Agency concerning timeliness of repairs. This bill would eliminate any requirement for a new prescription or prior authorization for the repair of a customized wheelchair from Medicaid or private health insurance, depending on the age of the wheelchair. This bill would further require a manufacturer of customized wheelchairs to provide needed product information, tools, and parts directly to the consumer or a repair provider that is not affiliated with the manufacturer. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 HB258 INTRODUCED Page 2 manufacturer. This bill would further provide that a manufacturer's failure to comply with the standards for assistance would be an unlawful trade practice, subject to enforcement by the Attorney General or an aggrieved owner under the Deceptive Trade Practices Act. A BILL TO BE ENTITLED AN ACT Relating to wheelchair repair; to amend Section 34-14C-6, Code of Alabama 1975, to provide the Board of Home Medical Equipment with authority to discipline licensees who fail to repair customized wheelchairs in a timely manner; to provide standards for timely repair of customized wheelchairs; to require Medicaid to cover the cost of customized wheelchairs when medically necessary; to limit the requirement of prior authorization by Medicaid or private health insurance for repair of certain customized wheelchairs; to impose a reporting requirement on Medicaid repair providers; to require manufacturers to provide the documentation, parts, or tools necessary to repair a motorized wheelchair to independent repair businesses on the same terms as provided to the manufacturer's authorized repair businesses; and to provide that a violation of this requirement is an unlawful trade 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 HB258 INTRODUCED Page 3 that a violation of this requirement is an unlawful trade practice under Chapter 19 of Title 8, Code of Alabama 1975. BE IT ENACTED BY THE LEGISLATURE OF ALABAMA: Section 1. (a) For the purposes of this section, the following terms have the following meanings: (1) CONSUMER. The individual who uses a a customized wheelchair in his or her residence, regardless of whether the purchase or lease of the wheelchair is funded in whole or in part by the consumer or by private or public health insurance. (2) CUSTOMIZED WHEELCHAIR. A manual or motorized wheelchair that is individually configured for the consumer with specialized equipment that requires evaluation, configuration, fitting, adjustment, programming, and long-term maintenance and repair services. (3) REPAIR PROVIDER. An authorized repair provider or an independent repair provider, both as defined in Section 5 of this act, that repairs customized wheelchairs and that may or may not be a home medical services provider subject to Chapter 14C of Title 34, Code of Alabama 1975. (b)(1) A repair provider shall make timely repair of a customized wheelchair according to the requirements of this subsection. (2) Upon request, a repair provider shall make timely repair of a customized wheelchair at the consumer's residence if the consumer attests that he or she is unable to have the wheelchair delivered to the repair provider's place of business. (3) A repair provider shall maintain and advertise an electronic mail address and a phone number so that a consumer 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 HB258 INTRODUCED Page 4 electronic mail address and a phone number so that a consumer may request a repair. (4)a. A repair provider fails to make timely repair of a customized wheelchair for any of the following reasons: 1. Failure to respond to a consumer who requests assessment or repair no later than the end of the first full business day after the consumer makes the request. 2. If the wheelchair is delivered to the repair provider's place of business, failure to assess and identify the repairs necessary no later than the end of the first full business day after delivery. 3. If the consumer is unable to have the wheelchair delivered to the repair provider's place of business, failure to assess and identify the repairs necessary no later than the end of the third full business day after submission of the request for assessment or repair by the consumer. 4. If the repair may be covered by private or public health insurance, failure to submit a request for prior authorization within one business day of identifying the necessary repairs. 5. Failure to order the parts required for repair no later than three business days after: (i) assessing the need for repair; and if required, (ii) receiving prior authorization from private or publicly funded health insurance. 6. Failure to repair the wheelchair no later than three business days after receiving the parts ordered. b. A repair provider makes timely repair of a customized wheelchair in any of the following circumstances: 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 HB258 INTRODUCED Page 5 customized wheelchair in any of the following circumstances: 1. The repair provider completes necessary repair of the wheelchair no later than 10 business days after the original request is submitted, even if the repair provided fails to comply with any requirement described in paragraph a. 2. The necessary repair is completed more than 10 business days after the original request is submitted because: (i) The consumer fails to make the wheelchair available for assessment or repair by missing an agreed upon appointment with the repair provider for an assessment or repair at the consumer's home or the repair provider's place of business; or (ii) Shipment of the parts necessary for repair are ordered but not received, or through no fault of the repair provider, the shipment omits necessary parts or contains the wrong parts; or (iii) Any other reason that is beyond the control of the repair provider, including a delay in receiving prior authorization from private or public health insurance. c. If a consumer is required to use a repair provider that is designated by private or publicly funded insurance, the requirements in paragraphs a. and b. shall become operative when the consumer initiates communication with the repair provider designated by the insurer. (c)(1) On and after October 1, 2026, the Board of Home Medical Equipment shall conspicuously post on its website an electronic mail address and phone number to receive complaints about a repair provider that is also a home medical services provider regarding failure to make timely repair of a customized wheelchair. 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 HB258 INTRODUCED Page 6 customized wheelchair. (2) Upon receiving a complaint pursuant to this subsection, the board may investigate a repair provider that is also a home medical services provider for cause pursuant to Section 34-14C-4, Code of Alabama 1975. Section 2. Section 34-14C-6, Code of Alabama 1975, is amended to read as follows: "§34-14C-6 (a) The board may deny, suspend, or revoke a license as provided in this section. (b) A license may not be denied, suspended, or revoked except by majority vote of the board and with prior notice and opportunity for hearing in accordance with this chapter and the Alabama Administrative Procedure Act. (c) The board may institute a hearing for denial, suspension, or revocation of a license , or any person may file a written complaint with the board seeking the denial, suspension, or revocation of an application for licensure or license issued by the board or the investigation of any unlicensed person or entity providing home medical equipment services. The complaint shall be in a form prescribed by the board. (d) A copy of the charges, including notice of the time and place of hearing, shall be served by certified mail, return receipt requested, at least 21 days before the scheduled hearing date to the most recent address of the applicant or licensee on file with the board, or to the last known address of any unlicensed person individual or entity providing home medical equipment services. If the notice and 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 HB258 INTRODUCED Page 7 providing home medical equipment services. If the notice and opportunity for hearing is refused or the return receipt has not been received by the board within 10 days before the scheduled hearing, the applicant, licensee, or unlicensed person individual or entity may be served by mailing the charges and notice by first class mail, at least seven days before the hearing date, to the most recent address on file with the board , or to the last known address of the unlicensed person individual or entity providing home medical equipment services. (e) The board may invoke disciplinary action as outlined in subsection (f) whenever it is established to the satisfaction of the board, after a hearing held in accordance with this chapter and the Alabama Administrative Procedure Act, that any person is guilty of any of the following acts: (1) Violation of this chapter or a rule of the board. (2) Making a material misrepresentation in furnishing information to the board. (3) Making a misrepresentation to obtain licensure or to otherwise violate this chapter. (4) Conviction of or entry of a plea of guilty or nolo contendere to any crime that is a felony under the laws of the United States, or any state or territory of the United States, or to any crime that is a misdemeanor, if an essential element of the crime is dishonesty or is directly related to providing home medical equipment services. (5) Gross negligence or gross misconduct in providing home medical equipment services. (6) Aiding, assisting, or willingly permitting another 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 HB258 INTRODUCED Page 8 (6) Aiding, assisting, or willingly permitting another person to violate any provision of this chapter or rule of the board. (7) Failing, within 30 days, to provide information in response to a written request of the board. (8) Failing to cooperate with an inspection or with an investigation conducted by the board. (9) Engaging in dishonorable, unethical, or unprofessional conduct of a character likely to deceive, defraud, or harm the public. (10) Denial, revocation, suspension, or restriction of a license in another state or jurisdiction to provide home medical equipment services for a reason other than failure to renew the license. (11) Directly or indirectly giving to or receiving from any person , partnership, corporation, or other legal entity any fee, commission, rebate, or other form of compensation for services not actually or personally rendered. (12) A finding that a licensee on probationary status has violated the terms of the probation. (13) Willfully making or filing false records, reports, or billings in the course of providing home medical equipment services including, but not limited to, false records, reports, or billings filed with state or federal agencies or departments. (14) The use of any words, abbreviations, figures, or letters with the intention of indicating practice as a home medical equipment services provider without having first obtained a license from the board. 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 HB258 INTRODUCED Page 9 obtained a license from the board. (15) Failure to comply with state or federal laws , rules, and regulations concerning home medical equipment services providers. (16) Solicitation of home medical equipment services using false or misleading advertising. (17) Failure to display a license in accordance with this chapter. (18) Failure to report a change of name, address, control, ownership, or administration to the board within 30 days after the date of change. (19) Repeated failure to make timely repair of a wheelchair as described in Section 1(b) of the act amending this section. (f) When the board finds any person guilty of any of the grounds set forth in subsection (e), the board may enter an order imposing one or more of the following penalties: (l) A letter of reprimand. (2) Imposition of probation for a period of time and subject to such conditions as may be prescribed by the board. (3) Denial of an application for an initial or renewal license. (4) Suspension of a license for a period of time established by the board, with or without automatic reinstatement. (5) Revocation of a license. (6) Payment of restitution to each consumer negatively affected by the prohibited act. Proof of such restitution shall be a signed and notarized release executed by the 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 HB258 INTRODUCED Page 10 shall be a signed and notarized release executed by the consumer or the estate of the consumer. (7) Assessment of the costs of the disciplinary proceedings. (g) Failure to comply with any final order of the board is also cause for suspension or revocation of a license. The board may suspend or revoke any license which that has been issued based on false or fraudulent representations. (h) The board may informally resolve any alleged violation of this chapter or rule of the board by stipulation, agreed settlement, or consent order, in lieu of an administrative hearing. (i) Any entity or person individual found to be providing home medical equipment services without a license as required by this chapter shall be subject to an administrative fine of up to one thousand dollars ($1,000) per day that services were provided without a license. Funds collected pursuant to this chapter shall be allocated to the administration of the program. (j) Any entity or person individual found to be providing home medical equipment services without a license as required by this chapter may be administratively enjoined by the board from providing services until such time as the entity or person complies with this chapter. (k) In addition to any other disciplinary action authorized by this chapter, the board may levy and collect administrative fines for violations of this chapter or the rules or standards of the board in an amount of up to one thousand dollars ($1,000) for each violation. 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 HB258 INTRODUCED Page 11 thousand dollars ($1,000) for each violation. (l) Any person individual or entity violating this chapter, upon conviction, shall be guilty of a Class A misdemeanor, and subject to fine or imprisonment, or both. (m) Any entity or person individual subject to the penalties prescribed by subsections (i) and (j) may pursue an appeal through the board according to rules promulgated adopted by the board. (n) Any hearings related to matters before the board shall be conducted in Montgomery County. (o) In addition to any other penalty or disciplinary action authorized by this chapter, the board may seek an injunction against any person individual or entity found in violation of this chapter. In an action for an injunction, the board may demand and recover a civil penalty of fifty dollars ($50) per day for each violation, reasonable attorney fees, and court costs. No civil penalty shall be awarded to the board if an administrative fine is assessed pursuant to subsection (i). (p) Upon the revocation or suspension of a license, the licensee shall immediately surrender the license to the board, and if the licensee fails to do so, the board may seize the license. (q) Any person aggrieved by an adverse action of the board may appeal the action to the Circuit Court of Montgomery County in accordance with the Alabama Administrative Procedure Act." Section 3. (a) As used in this section, the following words have the following meanings: 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 HB258 INTRODUCED Page 12 words have the following meanings: (1) AGENCY. The Alabama Medicaid Agency. (2) COMMISSIONER. The Commissioner of the Alabama Medicaid Agency. (3) CUSTOMIZED WHEELCHAIR. As defined in Section 1 of this act for a Medicaid recipient with a disability who is unable to achieve maximum mobility with a standard wheelchair. (4) REPAIR PROVIDER. As defined in Section 1 of this act. (5) STANDARD WHEELCHAIR. A manual or motorized wheelchair that is not individually configured for a consumer. (6) TIMELY REPAIR. As described in Section 1(b) of this act. (b) A customized wheelchair shall be covered under Medicaid only if it is medically necessary and a standard wheelchair does not meet the recipient's needs as determined by the agency. (c)(1) The commissioner shall not require a new prescription or prior authorization for the repair of a customized wheelchair unless the original prescription or authorization for the customized wheelchair is more than: (i) five years old in the case of a Medicaid recipient who is under 21 years of age; or (ii) seven years old in the case of a Medicaid recipient who is 21 years of age or older. (2) The commissioner shall grant prior authorization to the replacement of a customized wheelchair only upon a determination that repair of the wheelchair would not adequately meet the needs of the recipient. (d) No later than September 30, 2027, and annually 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 HB258 INTRODUCED Page 13 (d) No later than September 30, 2027, and annually thereafter, a repair provider that contracts with the agency shall submit a report concerning timely repair to the commissioner that includes for each repair request all of the following information: (1) The number of days to initially respond to the request. (2) The number of days to conduct a repair assessment. (3) Whether the repair assessment was made at the recipient's residence, the repair facility, remotely, or another location. (4) If prior authorization to make the repair was necessary, the number of days to receive the agency determination. (5) The number of days from the repair assessment to order a replacement part. (6) The number of days from the repair assessment to complete repair of the wheelchair, including the number of days to receive any replacement part ordered. (7) Whether the repair was completed at the recipient's residence, the repair facility, or another location. (e) The commissioner shall seek any federal approval necessary, including amendment of the state Medicaid plan or application for a waiver, to implement this section. (f) The commissioner shall adopt rules to implement this section. Section 4. (a) As used in this section, the following words have the following meanings: (1) CUSTOMIZED WHEELCHAIR. As defined in Section 1 of 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 HB258 INTRODUCED Page 14 (1) CUSTOMIZED WHEELCHAIR. As defined in Section 1 of this act. (2) HEALTH BENEFIT PLAN. a. Any plan, policy, or contract issued, delivered, or renewed in this state that provides health coverage that includes payment for hospitalization, physician care, treatment, surgery, therapy, drugs, equipment, and any other medical expense, regardless of the following: 1. Whether the plan, policy, or contract is provided by a health care insurer, health maintenance organization established under Chapter 21A of Title 27, Code of Alabama 1975, health care services plan established under Chapter 20 of Title 10A, Code of Alabama 1975, or any other entity that pays for, purchases, or reimburses for health care services. 2. Whether the plan is for a group or an individual. b. The term does not include accident-only, specified disease, individual hospital indemnity, credit, dental-only, Medicare supplement, long-term care, disability income, or other limited benefit health insurance policies, or coverage issued as supplemental to liability insurance, workers' compensation, or automobile medical payment insurance. (b) Every health benefit plan issued, delivered, or renewed on and after January 1, 2026, may not require a new prescription or prior authorization for the repair or replacement of a customized wheelchair unless the original prescription is more than five years old. Section 5. (a) For the purposes of this section, the following terms have the following meanings: (1) AUTHORIZED REPAIR PROVIDER. A person to whom an 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 HB258 INTRODUCED Page 15 (1) AUTHORIZED REPAIR PROVIDER. A person to whom an original manufacturer grants a license to use a trade name, service mark, or other proprietary identifier for the purpose of maintaining or repairing motorized wheelchairs on behalf of the original manufacturer. If the original manufacturer, in addition to selling, leasing, or supplying motorized wheelchairs, also directly performs maintenance and repair, the original manufacturer is the authorized repair provider. (2) CONSUMER. An individual who owns or leases a motorized wheelchair. (3) DOCUMENTATION. Any manual, diagram, reporting output, service code description, schematic diagram, security code, password, other guidance, or information necessary to maintain or repair a motorized wheelchair. (4) INDEPENDENT REPAIR PROVIDER. A person that is unaffiliated with an original manufacturer and engages in the maintenance or repair of motorized wheelchairs. (5) MAINTENANCE OR REPAIR. Services required to preserve the reliable performance of a motorized wheelchair; prevent malfunction or degradation due to use; correct a malfunction, including the diagnosis of a problem; remedy damage; or perform any other task required to restore a wheelchair to optimal functionality, including any product updates. (6) ORIGINAL MANUFACTURER. A person that sells, leases, or supplies new motorized wheelchairs that are also manufactured by or on behalf of the person. (7) PART. Any replacement part, whether new or used, provided by an original manufacturer for the purpose of 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 HB258 INTRODUCED Page 16 provided by an original manufacturer for the purpose of maintaining or repairing a motorized wheelchair. (8) TOOLS. Any software, hardware, or other apparatus used for the maintenance or repair of a motorized wheelchair, including software or another mechanism to program a new part, calibrate functionality, or perform any other function required. (b)(1) An original manufacturer shall make available, directly or through an authorized repair provider and in compliance with the terms required in subsection (c), any documentation, parts, or tools required for the maintenance or repair of a motorized wheelchair to the consumer or an independent repair provider. (2) The duty described in subdivision (1) includes, with respect to an electronic security lock or other security-related function, the provision of any documentation, tools, or parts required to access and reset the lock or function when disabled during the maintenance or repair of a motorized wheelchair. (3) The required documentation, parts, or tools may be provided to a consumer or independent repair provider through an appropriate secure release system. (c) An original manufacturer shall fulfill the duty imposed in subsection (b) in good faith, which means in accordance with the minimum terms required in this subsection. (1) Documentation shall be provided at no charge except for the actual cost of preparing and sending a physical copy. (2) Parts shall be provided on the same terms as would apply to an authorized repair provider, including all of the 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 HB258 INTRODUCED Page 17 apply to an authorized repair provider, including all of the following: a. Costs and terms equivalent to those that apply to an authorized repair provider, including any adjustments due to discount or rebate. b. Convenient and timely means of delivery. c. Parts identical to those available to an authorized repair provider to enable maintenance or repair that is at the current level of fully restored or updated functionality, including rights of use or other incentives or preferences given to an authorized repair provider. d. No obligation or restriction that is not imposed on an authorized repair provider. e. Without obligation to enter into a standing arrangement or contract with the original equipment manufacturer. (3) Tools shall be provided subject to the following conditions: a. At no charge, except for the actual cost of preparing and sending a tool in physical form. b. No additional authorization required to use or operate the tool. c. No additional impediment to access or use the tool or to enable full functionality of digital electronic equipment. d. With sufficient instructions that a reasonable repair provider may use a tool to immediately perform maintenance or repair with little or no independent research on the Internet or other public sources. 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 HB258 INTRODUCED Page 18 on the Internet or other public sources. (d) In complying with this section, an original manufacturer shall not be required to divulge any trade secret to a consumer or independent repair provider. (e) This section shall have no effect on the terms of an arrangement or contract between an original manufacturer and an authorized repair provider which includes, but is not limited to, maintenance or repair work by an authorized repair provider pursuant to a warranty or a recall, except that any term of the arrangement or contract that waives, avoids, restricts, limits, or interferes with the original manufacturer's duty to comply with this section shall be void. (f) An original manufacturer or authorized repair provider shall not be liable for any damage to, or malfunction of, a motorized wheelchair which results from the use of documentation, parts, or tools provided pursuant to this section to a consumer or an independent repair provider. (g) A failure to comply with this section shall be an unlawful trade practice under Chapter 19, Title 8, Code of Alabama 1975, subject to enforcement by the Attorney General pursuant to Section 8-19-4, Code of Alabama 1975, or an action by a consumer or independent repair provider pursuant to Section 8-19-10, Code of Alabama 1975. Section 6. This act shall become effective on October 1, 2026. 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500