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Agency warns proviso barring prior authorization for wheelchair repairs could increase fraud, delays
Summary
KDHE told the committee a legislative proviso removing prior authorization for complex wheelchair repairs may create waste and abuse risks; MCOs and KDHE outlined typical wheelchair authorization processes and said better options are targeted thresholds and stronger data monitoring.
KDHE and managed-care organization representatives told the committee on July 9 that a legislative proviso prohibiting prior authorization for complex wheelchair repairs and accessories could have unintended consequences. KDHE argued that targeted policy — for example removing prior authorization for low-cost repairs only — would balance prompt care for members and fraud-risk controls.
KDHE officials and MCO representatives described how complex wheelchair approvals typically require clinical assessment, multidisciplinary seating evaluations and physician documentation. Christine Osterlund, KDHE deputy secretary, said the state had been preparing…
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