law25297

Chapter 297

2025 -- H 5017 SUBSTITUTE A
Enacted 06/26/2025

A N A C T

RELATING TO COMMERCIAL LAW -- GENERAL REGULATORY PROVISIONS -- RIGHT TO CONSUMER ACCESS TO POWERED WHEELCHAIR REPAIRS

Introduced By: Representatives Diaz, Kislak, Bennett, Edwards, Giraldo, Shallcross Smith, Ajello, and Fogarty

Date Introduced: January 10, 2025

It is enacted by the General Assembly as follows:

SECTION 1. Title 6 of the General Laws entitled "COMMERCIAL LAW — GENERAL

REGULATORY PROVISIONS" is hereby amended by adding thereto the following chapter:

CHAPTER 61

RIGHT TO CONSUMER ACCESS TO POWERED WHEELCHAIR REPAIRS

6-61-1. Definitions.

For purposes of this chapter, unless the context otherwise requires:

(1) “Authorized repair supplier” means an individual or business who or that is unaffiliated

with an original equipment manufacturer and who or that has an arrangement with the original

equipment manufacturer, for a definite or indefinite period, under which the original equipment

manufacturer grants to the individual or business a license to use a trade name, service mark, or

other proprietary identifier for the purposes of offering the services of inspection, diagnosis,

maintenance, or repair of powered wheelchairs under the name of the original equipment

manufacturer, or other arrangement with the original equipment manufacturer to offer those

services on behalf of the original equipment manufacturer. An original equipment manufacturer

who or that offers the services of inspection, diagnosis, maintenance, or repair of its own powered

wheelchairs, and who or that does not have an arrangement with an unaffiliated individual or

business, shall be considered an authorized repair supplier with respect to that equipment.

(2) “Commissioner” means the health insurance commissioner.

(3) “Complex manual wheelchair” means manually driven complex wheelchair that can

accommodate rehabilitative accessories and features.

(4) “Complex power wheelchair” means a power-driven complex wheelchair, as defined

by the Center for Medicare and Medicaid Services (“CMS”) that is classified as a Group 2 power

wheelchair with power options that can accommodate rehabilitative features to include, but not

limited to, tilt in space; or a Group 3, Group 4 or Group 5 power wheelchair.

(5) “Complex rehabilitation technology (CRT)” or “complex wheelchair” means items 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, and shall include options and accessories related to

any of such items. Current healthcare common procedure coding system (“HCPCS”) shall fall

under the definition of complex rehabilitation technology, and any amendments to HCPCS

subsequently added or created by the federal government shall be included within the definition of

complex rehabilitation technology and shall be added to the covered HCPC list.

(6) “Complex rehabilitation wheelchair manufacturer” or “manufacturer” means a person

or company who or that designs, develops, tests, and produces finished systems or components of

those systems and sells all products or components to:

(i) Authorized providers for distribution; or

(ii) To other manufacturers for the production of more complex wheelchair systems.

Manufacturers are also responsible for maintaining compliance with relevant production

regulations and standards and reporting as designated by federal and state authorities.

(7) “Consumer” means a member of a health carrier who or that uses a complex rehab

technology with which the CRT supplier has a contractual relationship.

(8) “Consumer-owned backup complex power wheelchair” means a retired power

wheelchair, that can be safely used by the consumer when a manual backup or suitable loaner

wheelchair cannot be supplied to meet the consumer’s medical needs.

(9) “Covered person” means a policyholder, subscriber, or other person participating in a

policy, contract, or plan that provides for third-party payment or prepayment of health or medical

expenses.

(10) “Defect” means an abnormality that impairs the quality, function, or utility of a

wheelchair from its intended design and purpose.

(11) "Department" means the department of business regulation established pursuant to the

provisions of chapter 14 of title 42.

(12) “Embedded software” means any programmable instructions provided on firmware

delivered with an electronic component of equipment, or with a part for that equipment, for

purposes of equipment operation, including all relevant patches and fixes made by the manufacturer

of the equipment or part for these purposes.

(13) “Evaluation/diagnostic time” means time and labor during which a qualified

technician troubleshoots and diagnoses any wheelchair adjustments or repair needs.

(14) “Executive office” means the executive office of health and human services, the

agency designated by state law and the Medicaid state plan as the Medicaid single state agency.

(15) “Fair and reasonable terms and costs,” with respect to obtaining manufacturer

documentation, parts, embedded software, firmware, or tools from a manufacturer to provide

services, means terms that are equivalent to the most favorable terms that the manufacturer offers

to an authorized repair supplier and costs to the buyer that are no greater than the manufacturer’s

suggested retail price:

(i) For documentation, including any relevant updates, “fair and reasonable terms and

costs” also means at no charge, except that, when the documentation is requested in physical printed

form, a charge may be included for the reasonable actual costs of preparing and sending the copy;

(ii) For software tools, “fair and reasonable terms and costs” also means all of the

following:

(A) Provided at no charge and without requiring authorization or Internetinternet access;

(B) Without imposing impediments to access or use, in the course of effecting the

diagnosis, maintenance, or repair and without impairing the efficient and cost-effective

performance of the diagnosis, maintenance, or repair;

(iii) If an original equipment manufacturer does not utilize an authorized repair supplier,

“fair and reasonable terms and costs” means an equitable price charged to the buyer in consideration

of the actual cost to the original equipment manufacturer to prepare and distribute the part, tool,

service access method, or documentation, exclusive of any research and development costs

incurred.

(16) “Firmware” means a software program or set of instructions programmed on

equipment, or on a part for that equipment, to allow the equipment or part to communicate within

itself or with other computer hardware.

(17) “Health careHealthcare professional” means an individual who is licensed,

registered, or certified under federal or state law or regulation to provide health carehealthcare

services.

(18) “Health plan” or “payer” means an entity subject to the insurance laws of this state, or

subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide health

insurance coverage including, but not limited to, an insurance company, a health maintenance

organization and a nonprofit hospital and medical service corporation.

(19) “Independent repair provider” means an individual or business, other than the

manufacturer, that is engaged in the services of inspection, diagnosis, maintenance, or repair of

equipment for the purposes of returning it to the safety and performance specifications established

by the manufacturer and to meet its original intended use.

(20) “Inoperable” means when a wheelchair becomes unusable due to a mechanical or

electronic breakdown or failure.

(21) “Loaner” means a properly working wheelchair that performs the essential functions

of the original wheelchair and that is provided to the consumer on a temporary basis while the

consumer’s wheelchair is being repaired/replaced. A “loaner” wheelchair is further defined to be

in good working order, does not create any threat to the consumer’s health or safety, and need not

be new or identical to or have the same functional capabilities as those of the original wheelchair.

(22) “Manufacturer documentation” means any manual, diagram, reporting output, service

code description, schematic, or other guidance or information used in effecting the services of

inspection, diagnosis, maintenance, or repair of powered wheelchairs.

(23) “Medical documentation” means any chart notes, letters of medical necessity,

prescriptions, or other clinical documentation demonstrating the initial or continued medical

necessity of qualifying complex rehabilitation technology.

(24) “Non-conformity” means a condition or defect that significantly impairs the use,

value, function, or safety of an assistive device or any of its components, but does not include a

condition or defect of the device that is the result of:

(i) Abuse, misuse, or neglect by a consumer;

(ii) Modifications or alterations not authorized by the manufacturer;

(iii) Normal wear;

(iv) Normal use which may be resolved through a fitting adjustment, routine maintenance,

preventative maintenance, or proper care; or

(v) A consumer's failure to follow any manufacturer's written service and maintenance

guidelines furnished to the customer at the time of purchase.

(25) “Prior authorization” means any requirement held by the payer that the covered person

or the qualified complex rehabilitation technology supplier obtain written or verbal approval from

the payer [or other insurer] before completing needed services or providing equipment to a covered

person.

(26) “Qualified complex rehabilitation technology professional” means an individual who

is certified as an assistive technology professional (ATP) by a professional organization providing

certification of assistive technology professions.

(27) “Qualified complex rehabilitation technology supplier” or “supplier” means a

company or entity that meets all of the following criteria:

(i) Is accredited by a recognized accrediting organization as a supplier of complex

rehabilitation technology;

(ii) Is an employer of at least one qualified complex rehabilitation technology professional

to analyze the needs and capacities of the complex needs consumer in consultation with qualified

health carehealthcare professionals, to participate in the selection of appropriate complex

rehabilitation technology for those needs and capacities of the complex needs consumer, and to

provide training in the proper use of the complex rehabilitation technology;

(iii) Requires a qualified complex rehabilitation technology professional to be physically

present for the evaluation and determination of appropriate complex rehabilitation technology for

a complex needs consumer;

(iv) Has the capability to provide service and repair by trained technicians for all complex

rehabilitation technology it sells; and

(v) Provides written information at the time of delivery of the complex rehabilitation

technology to the complex needs consumer stating how the complex needs consumer may receive

service and repair for the complex rehabilitation technology.

(28) “Recipient” means a person receiving benefits under the state Medicaid program,

including a person whose Medicaid eligibility is being redetermined.

(29) “Third-party payer” means an entity other than the consumer of healthcare supplier,

that reimburses and manages health care expenses, such as insurance companies and government

payers.

(30) “Tools” means any software program, hardware, or other apparatus used in inspection,

diagnosis, maintenance, or repair of powered wheelchairs, including software or other mechanisms

that provision, program, or pair a new part, calibrate functionality, or perform any other function

required to bring the product back to fully functional condition.

(31) “Trade secret” shall have the same meaning as set forth in § 6-41-1.

(32) “Trip/travel allowance” means compensation for travel to the recipient’s home or

location for the purpose of facilitating a repair to a complex wheelchair.

(33) “Warranty” means a guarantee made by a manufacturer regarding the integrity or

condition of the product and the terms and conditions under which repairs, refunds, or exchanges

shall be made if the product does not function as originally described or intended within a specified

period.

6-61-2. No prior authorization for repair of complex wheelchairs.

(a) A health plan’s coverage and payment of complex wheelchair repairs shall not require:

(1) A qualified complex rehabilitation technology supplier to obtain any form of prior

authorization; or

(2) Any medical documentation to complete repairs for consumer-owned complex

rehabilitation technology.

(b) The complex rehabilitation technology supplier shall maintain documentation of any

repairs and/or maintenance completed for consumer-owned complex wheelchairs. Such

documentation shall not be subject to general audits.

6-61-3. Requirement for suppliers to service what they sell.

A supplier who or that sells complex power or complex manual wheelchairs shall meet

the criteria of a "qualified complex rehabilitation technology supplier", as defined in § 6-61-1 and

for complex wheelchairs that a supplier has sold, the supplier is required to offer service and repairs

during the wheelchair’s useful life expectancy, unless:

(1) The consumer has moved outside of the original supplier's service area;

(2) The damage that requires repair is the result of consumer abuse or misuse of the

equipment that restricts coverage by the client's health plan, and the client refuses to pay for the

repairs; or

(3) The consumer or their representative poses a potential threat to the health and safety of

the supplier or is otherwise abusive.

6-61-4. Consumer access to parts -- Self repairs.

(a) For the purpose of providing services for power wheelchair equipment, an original

equipment manufacturer shall, with fair and reasonable terms and costs, make available, as defined

in § 6-61-1, to an independent repair supplier or consumer of the manufacturer’s equipment,

manufacturer documentation, parts, embedded software, firmware, or tools that are intended for

use with the equipment or any part, including updates to documentation, parts, embedded software,

firmware, or tools.

(b) With respect to power wheelchair equipment that contains an electronic security lock

or other security-related function, an original power wheelchair equipment manufacturer shall, with

fair and reasonable terms and costs, make available to independent repair suppliers and owners any

manufacturer documentation, parts, embedded software, firmware, or tools needed to reset the lock

or function when disabled in the course of providing services. The manufacturer may make the

documentation, parts, embedded software, firmware, or tools available to independent repair

suppliers and consumers through appropriate secure release systems.

independent repair supplier. This section shall not apply to any part(s) requiring programmability,

calibration, or clinical involvement to ensure appropriate consumer seating and positioning. Items

included in this section for powered wheelchairs shall include:

(1) Batteries;

(2) Battery chargers;

(3) Nonprogrammable joysticks;

(4) Joystick housings or brackets;

(5) Wheel assembly;

(6) Non-positioning accessories;

(7) Anti-tip devices;

(8) Armrests, excluding positioning components, designed for adjustment by a therapist or

assistive technology professional;

(9) Caster spheres;

(10) Cosmetic shrouding; and

(11) Nonpowered leg lowers.

(d) This chapter does not require an original power wheelchair equipment manufacturer to

divulge a trade secret, except as necessary to provide documentation, parts, tools, service access

methods, and training courses and materials on fair and reasonable terms. An original equipment

manufacturer may redact documentation to remove trade secrets from the documentation before

providing access to the documentation if the usability of the redacted documentation for the purpose

of providing services is not diminished. An original equipment manufacturer may withhold

information regarding a component of, design of, functionality of, or process of developing a part,

embedded software, firmware, or a tool if the information is a trade secret and the usability of the

part, embedded software, firmware, or tool for the purpose of providing services is not diminished.

(e) An original power wheelchair manufacturer which fails to produce a replacement part

because the part is out of stock and the manufacturer is unable to obtain the part, shall not be subject

to the penalties as provided in chapter 13.1 of this title6if the original equipment manufacturer does

the following:

(1) Informs the consumer or independent repair provider that the part is out of stock, and,

consequently, the manufacturer is unable to obtain the part; and

(2) Makes the part available to the consumer or independent repair provider within five (5)

business days of when the part becomes available.

(f) An original equipment manufacturer is not liable for faulty or otherwise improper

repairs provided by independent repair suppliers or owners, including faulty or otherwise improper

repairs that cause any of the following:

(1) Damage to a powered wheelchair that occurs during the repairs;

(2) Any indirect, incidental, or consequential damages; or

(3) An inability to use, or a reduced functionality of, a powered wheelchair resulting from

faulty or otherwise improper repair.

6-61-5. Rules and regulations.

The department of business regulation may promulgate rules and regulations to implement

and enforce the provisions of §§ 6-61-2, 6-61-3 and 6-61-2.

6-61-6. Application and scope.

(a) This chapter applies to the following classes of third-party payment supplier contracts,

policies, or plans delivered, issued for delivery, continued, or renewed in this state on or after

January 1, 2026:

(1) Individual or group accident and sickness insurance providing coverage, pursuant to

chapter 18 of title 27, on an expense incurred basis; and

(2) An individual or group hospital, chapter 19 of title 27 or medical service contract issued

pursuant to chapter 20 of title 27; and

(3) An individual or group health maintenance organization contract regulated under

chapter 41 of title 27; and

(4) A plan established for public employees pursuant to chapter 12 of title 36; and

(5) The medical assistance program under chapter 8 of title 40 including all managed care

organizations acting pursuant to a contract with the executive office of health and human services

to administer the medical assistance program.

(b) The commissioner may promulgate rules and regulations to implement and enforce the

provisions of this section.

SECTION 2. This act shall take effect upon passage.

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LC000432/SUB A

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