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HF 425

A bill for an act relating to reimbursement for the repair of complex rehabilitation technology under the Medicaid program.

2025-2026 Regular Session Introduced by Josh Turek

Allows Medicaid to reimburse CRT repairs without prescription or prior authorization if the device was previously prescribed and reimbursed.

Introduced, referred to Health and Human Services.
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Bill Summary · HF 425

HF 425 — Summary

Overview

HF 425 is an introduced bill (introduced February 17, 2025) that addresses reimbursement for the repair of complex rehabilitation technology (CRT) under Minnesota’s Medicaid program. The bill applies to both Medicaid managed care and fee-for-service administrations. It specifies that the Department of Health and Human Services shall not require a prescription or prior authorization for reimbursement of a provider for the repair of CRT, provided the CRT was previously prescribed and reimbursed under Medicaid.

Primary sponsor: TUREK

Purpose and intent

  • Streamline reimbursement for the repair of complex rehabilitation technology by removing the requirement for a prescription or prior authorization when repairing CRT that has been previously prescribed and reimbursed under Medicaid.
  • Ensure continued access to and function of CRT devices for Medicaid beneficiaries who rely on these technologies for daily living and medically necessary purposes.

Key provisions

  • Reimbursement process:
    • Under both Medicaid managed care and fee-for-service administration, providers shall not be required to obtain a prescription or prior authorization to reimburse for CRT repairs.
    • The exception applies only when the CRT has been previously prescribed and reimbursed under Medicaid.
  • Definition of complex rehabilitation technology:
    • CRT is defined as items that Medicare classifies as durable medical equipment (DME), which are individually configured to meet an individual’s specific medical, physical, and functional needs.
    • CRT aims to support basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs) identified as medically necessary.

Definitions

  • Complex rehabilitation technology: Medicare-classified DME items that are uniquely configured for an individual to address specific medical, physical, and functional requirements, including ADLs and IADLs that are medically necessary.

Affected parties and entities

  • Medicaid beneficiaries who rely on CRT.
  • CRT providers and repair technicians.
  • Minnesota Department of Health and Human Services (DHHS), specifically the Medicaid program under both managed care and fee-for-service models.
  • Medicaid managed care organizations (MCOs) and Medicaid fiscal/administrative programs.

Procedural and timeline aspects

  • Status: Introduced; referred to Health and Human Services.
  • Introduced date: February 17, 2025.
  • No additional committee actions, fiscal notes, or sunset/expiry provisions described in the introduced text provided.

Potential impacts and considerations

  • Administrative impact: Likely reduces paperwork and processing time for CRT repairs by eliminating the need for prescriptions or prior authorizations in eligible cases.
  • beneficiary impact: Potentially faster repairs and reduced interruptions in device use, supporting ongoing functioning and independence.
  • fiscal impact: Could influence Medicaid repair expenditures by removing authorization barriers; exact financial effects depend on the volume of CRT repairs previously requiring authorization and the terms of prior reimbursements.
  • safeguards: The bill relies on the CRT having been previously prescribed and reimbursed, which may limit misuse; no explicit new prior authorization is required for repairs in these cases.

Next steps

  • The bill would proceed to committee action in Health and Human Services, where amendments, fiscal notes, and potential floor consideration would be determined.

Note: This summary reflects the introduced text as of February 17, 2025. The bill’s language could change through amendments or subsequent legislative actions.

Compiled from official sources — confirm details with the bill’s official record.

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