Iowa Medicaid recipients are no longer required to get a prescription for wheelchair repairs under a new administrative rules implemented by state officials last month.
Beginning July 1, the Iowa Department of Health and Human Services dropped an administrative policy that required an in-person doctor's appointment and a prescription in order for Medicaid to cover wheelchair repairs.
"The Iowa Department of Health and Human Services (HHS) recognizes the concerns related to barriers and delays involving member wheelchair repairs and is working to best serve our members," the agency wrote in a letter to medical equipment suppliers last month.
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Removing this requirement eliminates a major barrier for Iowans with disabilities, said State Rep. Josh Turek, D-Council Bluffs. It could take some Iowans weeks or months to complete the steps required under the previous policy, potentially leaving them homebound until their equipment could be fixed.
“This isn't perfect. There's still more that we need to do, but this is meaningful," said Turek, who is a wheelchair user. "I realized to an able-bodied person, this may seem like a very small change, but I promise you, for those that this affects — wheelchair users, power wheelchair users — this is a monumental change.”
The policy still requires recipients to receive prior authorization for the repair from their managed care organization or the insurers that provide Medicaid coverage to Iowans.
The managed care organizations say they aim to complete prior authorizations within seven to 10 days. Turek said that shortens the time it takes for many Iowans to have their equipment repaired because it removes the logistical problem of scheduling and going to an in-person doctor's appointment. That will be a significant improvement for those who live in rural areas, lack reliable transportation or otherwise face other barriers to care.
“It’s going to take weeks or months off the process, undeniably," Turek said. "If your wheelchair is already broken and you’re holed up in your house, now you no longer need to go to the doctor. You no longer need to wait for that. Actually, as soon as you get that prior authorization, you don’t need to go anywhere, the repairman can come to you and get your wheelchair repaired.”
Effort to legislate change lead to policy being dropped
Turek sponsored a bill in the 2024 legislation session, House File 2589 , that would have done away with the prescription requirement. The Iowa House unanimously approved another bill removing the requirement, but the Senate did not take it up before key legislative deadlines.
Still, Turek said, the legislation prompted discussions with top health and human services officials, who acknowledged the need to address the barrier for vulnerable Medicaid populations and made the policy change.
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Turek said he hopes to continue discussions with HHS officials on other avenues to help improve care for Iowans with disabilities. He pointed to another provision in his bill that would have established a "work without worry" program allowing individuals with disabilities to retain Medicaid benefits even if holding a job places them above the income and asset threshold.
“This is the first step, by no means the end of the road here," he said. "I'm going to continue to work there. We need to put some guard rails in place.”
Michaela Ramm covers health care for the Des Moines Register. She can be reached at mramm@registermedia.com , at (319) 339-7354 or on Twitter at @Michaela_Ramm .
This article originally appeared on Des Moines Register: Prescription no longer required for Iowa Medicaid coverage of wheelchair repairs
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