Okla. Stat. tit. 56 § 1012.2

Current through Laws 2024, c. 453.

Section 1012.2 - Definitions

As used in the Commitment to Care for People with Complex Physical Disabilities Act:

1. "Complex physical disability" means a diagnosis or medical condition that results in significant physical impairment and/or functional limitation. Such term shall include, but not be limited to, individuals with spinal cord injury, traumatic brain injury, cerebral palsy, muscular dystrophy, spina bifida, osteogenesis imperfecta, arthrogryposis, amyotrophic lateral sclerosis, multiple sclerosis, demyelinating disease, myelopathy, myopathy, progressive muscular atrophy, anterior horn cell disease, post-polio syndrome, cerebellar degeneration, dystonia, Huntington's disease, spinocerebellar disease, and certain types of amputation, paralysis, or paresis that result in significant physical impairment and/or functional limitation. The term "complex physical disability" does not negate the requirement that an individual meet medical necessity requirements under Oklahoma Health Care Authority rules to qualify for receiving complex rehabilitation technology;

2. "Complex rehabilitation technology" (CRT) means items classified within the Medicaid program as of January 1, 2013, as durable medical equipment that are individually configured for individuals to meet their specific and unique medical, physical, and functional needs and capacities for basic activities of daily living and instrumental activities of daily living identified as medically necessary. Such items shall include, but not be limited to, complex rehabilitation manual and power wheelchairs and options/accessories, adaptive seating and positioning items and options/accessories, and other specialized equipment such as standing frames and gait trainers and options/accessories;

3. "Employee" means a person whose taxes are withheld by a qualified CRT supplier and reported to the Internal Revenue Service;

4. "Healthcare Common Procedure Coding System (HCPCS)" means the billing codes used by Medicare and overseen by the federal Centers for Medicare and Medicaid Services that are based on the current procedural technology codes developed by the American Medical Association;

5. "Individually configured" means a device has a combination of sizes, features, adjustments, or modifications that a qualified complex rehabilitation technology supplier can customize to the specific individual by measuring, fitting, programming, adjusting, or adapting the device as appropriate so that the device is consistent with an assessment or evaluation of the individual by a qualified health care professional and consistent with the individual's medical condition, physical and functional needs and capacities, body size, period of need, and intended use;

6. "Qualified complex rehabilitation technology professional" means an individual who is certified as an Assistive Technology Professional (ATP) by the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA);

7. "Qualified complex rehabilitation technology supplier" means a company or entity that:

a. is accredited by a recognized accrediting organization as a supplier of CRT,

b. is an enrolled Medicare supplier and meets the supplier and quality standards established for durable medical equipment suppliers, including those for CRT, under the Medicare program,

c. employs as a W-2 employee at least one qualified CRT professional for each location to:

(1) analyze the needs and capacities of the complex-needs patient in consultation with qualified heath care professionals,

(2) participate in the selection of appropriate CRT for such needs and capacities, and

(3) provide technology-related training in the proper use of the CRT,

d. requires a qualified complex rehabilitation technology professional be physically present for the evaluation and determination of appropriate CRT,

e. has the capability to provide service and repair by qualified technicians for all CRT it sells, and

f. provides written information to the complex-needs patient prior to ordering CRT as to how the complex-needs patient may receive service and repair; and

8. "Qualified health care professional" means a health care professional licensed by the State Department of Health who has no financial relationship with a qualified complex rehabilitation technology supplier. Qualified health care professional includes, but is not limited to:

a. a licensed physician,

b. a licensed physical therapist,

c. a licensed occupational therapist, or

d. other licensed health care professional who performs specialty evaluations within the professional's scope of practice.

Okla. Stat. tit. 56, § 1012.2

Added by Laws 2015, c. 324,s. 3, eff. 11/1/2015.