Providers urge removal of prior authorization for complex-rehab repairs and funding for certified wheelchair seating clinics

Representatives of complex rehab technology suppliers, the Cerebral Palsy Research Foundation (CPRF) and family members testified that prior authorization delays and frequent denials by Medicaid managed care organizations (MCOs) are leaving medically necessary wheelchairs, replacements and custom seating unavailable for Kansans with severe physical disabilities.

Wayne Graub, executive director of the National Coalition for Assistive and Rehab Technology (NCART), told the Committee that repair prior authorizations can take about 17 days and that 98.2 percent of prior authorizations are ultimately approved nationally. He said the delay forces suppliers to re‑visit consumers and prolongs unsafe situations where power chairs or critical components are not functioning.

Multiple witnesses from the Cerebral Palsy Research Foundation of Kansas described long waits and denied claims for custom-molded seats, power chairs and specialized trays. John Cuff, an occupational therapist at CPRF, said the clinic served 843 unduplicated clients last year and that custom wheelchairs can take three months in an ideal case but are averaging much longer because of MCO denials. Pat Jonas, CPRF president, said the average time from evaluation to delivery for a wheelchair has risen to 147 days in Kansas compared with 92 days in nearby states and 104 days in Oklahoma. Don Meniere and his daughter Haley described how customized seating prevented pressure wounds and preserved Haley’s independence.

CPRF asked the committee for two principal changes: (1) exempt certified state wheelchair and posture seating clinics from preauthorization when a qualified clinic team (OT/PT, ATP-certified provider, and credentialed technicians) has completed an evaluation and written order; and (2) provide additional SGF support to CPRF’s $1.3 million operating budget, including a requested $263,000 SGF increase to close an anticipated shortfall. Pat Jonas framed the proposal as protecting clinical expertise and reducing clinician time spent writing letters of medical necessity that could otherwise be spent evaluating patients.

Speakers also asked the committee to consider payment for travel and repair-assessment time for vendors serving widely rural areas, and to allow preventive maintenance rather than requiring repairs only after breakdown. "When a chair goes down and we call it a hard down or it just stops operating, that consumer could be stuck," NCART’s Wayne Graub said. "We just want to be able to fix it if we see it beforehand and get that done so that consumer is not in that position."

Context and next steps: The requests combine policy changes (prior-authorization exemptions for certified clinics) with supplemental SGF support to sustain a small number of accredited seating clinics that serve much of western and central Kansas. Committee members asked for details about denial rates and turnaround times, which will be included in committee staff follow-up.

No formal legislative action or vote was taken at the hearing.