FAST Repairs for Wheelchairs Act

Overview

HR 9364, the FAST Repairs for Wheelchairs Act, introduced in the 119th Congress, aims to remove prior authorization requirements under Medicare Advantage (MA) plans for maintenance and repairs of complex rehabilitation technology (CRT), specifically certain complex rehabilitative wheelchairs and related accessories. The bill would apply to MA plan years beginning on or after January 1 following enactment.

Purpose and intent

• Improve access to timely repairs for wheelchairs and related CRT by prohibiting MA plans from imposing prior authorization, medical documentation, or prescription requirements for repairs covered under CRT.
• Preserve existing process for initial evaluation of medical necessity or replacement due to loss, irreparable damage, or replacement upon end of useful life or after five years of use.
• Clarify what constitutes CRT for the purposes of the prohibition.

Key provisions

• Amend MA benefits provision (Section 1852(a)(1)(B) of the Social Security Act) to add a new clause prohibiting prior authorization for maintenance and repairs of CRT.
  • Subsection targets plan years beginning after the date of enactment.
• Specific prohibitions (for CRT repairs under MA plans):
  • No prior authorization requirements.
  • No prescription requirements.
  • No medical documentation requirements for coverage of CRT repairs.
• Clarifications and limitations:
  • Prior authorization may still apply to initial evaluation of medical necessity for the CRT.
  • Prior authorization may apply to the replacement of CRT when due to loss or irreparable damage.
  • Can apply when the CRT reaches its reasonable useful lifetime, or after five years of use.
• Definition of Complex Rehabilitation Technology (CRT):
  • Includes certain complex rehabilitative power wheelchairs, complex rehabilitative manual wheelchairs, and certain manual wheelchairs, plus related accessories furnished in connection with these items.
  • The definition references terms as used in current law (e.g., sections describing CRT in Medicare context).

Who is affected

• Medicare Advantage plans (MA plans): Prohibited from imposing prior authorization, prescription, or medical documentation requirements for CRT repairs covered under the plan, for plan years after enactment.
• Beneficiaries using CRT: Potentially benefit from faster and less burdensome access to repairs and maintenance for complex wheelchairs and related devices.
• Providers and suppliers of CRT: May experience changes in documentation requirements and authorization processes for repairs, with reduced administrative hurdles for repairs (subject to the stated exceptions).

Procedural and timeline aspects

• Introduction date: June 18, 2026.
• Referral: House Committee on Ways and Means and Committee on Energy and Commerce for consideration of provisions within their jurisdictions.
• Effective date: For plan years beginning on or after January 1 following enactment (i.e., prospective application after enactment).
• No immediate funding or implementation mechanism specified in the text provided beyond the statutory amendment.

Potential impact

• Access: Likely to reduce delays in obtaining repairs for CRT under MA plans, improving mobility and independence for wheelchair users.
• Administrative burden: Could reduce paperwork and prior authorization bottlenecks for repairs, while preserving essential steps for initial medical necessity evaluation and for replacement in certain scenarios.
• Coverage scope: Applies specifically to repairs of CRT; does not eliminate prior authorization for other MA plan benefits or for initial evaluations and replacements unrelated to repairs.

Summary

The FAST Repairs for Wheelchairs Act seeks to ensure timely maintenance and repair of complex rehabilitation technology by MA plans by prohibiting prior authorization, prescription, and medical documentation requirements for CRT repairs, while maintaining reasonable safeguards for initial evaluations and replacements. It defines CRT to include certain wheelchairs and related accessories and sets a prospective implementation for plan years after enactment.