Our wheelchair is our legs. It allows us to lead our lives. If we cannot use our wheelchair because it needs a repair, our daily activity stops. Because we use our wheelchairs every day, often up to 16 hours a day, and because Medicare and insurance providers require our wheelchairs to have a useful life of up to five years, wheelchair repairs are an inevitable part of being a wheelchair user.&nbsp;&nbsp;&nbsp;
When we obtain a new wheelchair, a medical prescription and prior authorization are required.Clinicians customize the wheelchair to fulfill our individual medical and functional needs. Our wheelchairs can cost tens of thousands of dollars and replacement parts are equally expensive. These factors, and a variety of others, very often delay repairs. These delays threaten our health, our safety and our basic daily activities.&nbsp;&nbsp;
A survey study of individuals with a spinal cord injury, who use medically prescribed and individually customized wheelchairs with complex rehab technology (CRT), found that the median time to repair a wheelchair was 14 days. The longest was 6 months, the entire length of the study period. Additionally, “nearly a quarter of participants reported having unmet repair needs with not all needed repairs completed.”&nbsp;&nbsp;
In their conclusion citing an earlier study, researchers added, “Further, individuals who experience consequences secondary to breakdowns have 1.73 times greater odds of pressure injuries, 1.81 times greater odds of rehospitalization, and worsened pain.” Finally, researchers concluded that the current provider-dependent repair process, “seems to indicate structural inadequacies within the repair process and the need for interventions to address these issues.” We agree and we believe that it is urgent that Congress acts tonstreamline the wheelchair repair process with the following planned legislation.&nbsp;
Please ask your members of Congress to support legislation due to be introduced by Senator Tammy Duckworth (D-IL) and Representative John Larson (D-CT) to address systemic issues in the wheelchair repair process. We support including provisions that would:&nbsp;&nbsp;
<ul>
<li>Remove prior authorization requirements for Medicare Advantage Plans for CRT repair. Since prior authorization is required to purchase a wheelchair, requiring it again for every repair is unnecessary red tape. It delays repairs significantly, often by weeks. Medicare has ended prior authorization for repairs. Medicare Advantage plans should as well. States should end similar requirements with their Medicaid programs.</li>
<li>Create a model to evaluate the benefits/costs of covering preventive maintenance. Provide a multiyear model of routine preventative maintenance services for medically prescribed, individually customized wheelchairs. Evaluate if the model produces less wait times, fewer repairs and lower costs. Include testing, adjusting, regulating, inspecting, and other services to maintain technology. The wheelchair industry recognizes the value of preventive maintenance to all stakeholders involved; please see repair guidelines they have developed.</li>
<li>Reimburse wheelchair repair technicians’ transportation costs. Payment for the time that certified repair technicians spend traveling to our home to diagnose needed repairs or for preventive maintenance and to provide service and repair services.  This would support the cost of our obtaining needed repairs</li>
<li>Keep us informed. Provide us an expected timeline for repairs. If our wheelchair cannot be repaired at our home, can a loaner wheelchair be provided? </li>
<li>Build a list of wheelchair components that we can repair, or have repaired, ourselves. Consult advocacy organizations and wheelchair providers to provide guidance on which wheelchair components we can repair or have repaired by someone other than our wheelchair provider. This is also an opportunity for more businesses, such as bike shops, to expand into wheelchair repairs.&nbsp;</li>
</ul>

Support Sensible Wheelchair Repair Reform

National Action for Wheelchair Repair Reform

Please ask your members of Congress to support legislation to address systemic issues in the wheelchair repair process.

I am alerting you that service challenges and extensive repair delays are commonplace and a source of great frustration for wheelchair users. The result is that 5.5 million American wheelchair users face extensive delays in obtaining functioning mobility equipment that enables them to work, go to school, and do everyday activities in the community. Having a functioning and safe chair is critical to full independence. Common issues such as incorrect seating, brake pads that have worn down or punctured tire tubes can be unsafe for the wheelchair user. Repair breakdowns are unfortunately happening every day, and obtaining timely, accurate repairs is currently next to impossible.

The procurement of customized and individually-configured wheelchairs is a multi-step and multi-stakeholder process including wheelchair users, durable medical equipment providers and manufacturers, and physical and occupational therapists. From customer intake to the delivery of customized components and needed repairs, it can be as many as 17 steps including checking insurance coverage, scheduling a repair technician assessment, processing the prior authorization process, ordering parts, scheduling a wheelchair clinic or home appointment, and billing, which altogether can take from weeks to many months. 

A prior authorization process should not be required to verify the need for an individually-configured manual or power wheelchair for a person who has a medically-prescribed long-term disability. To help minimize the repair delay, individuals who use complex rehab technology manual or power wheelchairs should be permitted to self-repair their wheelchairs or have them repaired by an independent repair provider, if they choose, and to purchase some items directly from manufacturers to expedite the repair process.

Please join Sen. Tammy Duckworth (D-IL) and Rep. John Larson (D-CT) in supporting forthcoming common sense legislation to address systemic issues in the wheelchair repair process.

We support including provisions that would:

•	Remove prior authorization requirements for Medicare Advantage Plans for CRT repair. Since prior authorization is required to purchase a wheelchair, requiring it again for every repair is unnecessary red tape. It delays repairs significantly, often by weeks. Medicare has ended prior authorization for repairs. Medicare Advantage plans should as well. States should end similar requirements with their Medicaid programs. 

•	Create a model to evaluate the benefits/costs of covering preventive maintenance. Provide a multiyear model of routine preventative maintenance services for medically prescribed, individually customized wheelchairs. Evaluate if the model produces less wait times, fewer repairs and lower costs. Include testing, adjusting, regulating, inspecting, and other services to maintain technology.

•	Reimburse wheelchair repair technicians’ transportation costs. Payment for the time that certified repair technicians spend traveling to our home to diagnose needed repairs or for preventive maintenance and to provide service and repair services.  This would support the cost of our obtaining needed repairs or preventive maintenance at home for a wheelchair that is, or soon may be, inoperable.

•	Keep us informed. Provide us an expected timeline for repairs. If our wheelchair cannot be repaired at our home, can a loaner wheelchair be provided? 

•	Build a list of wheelchair components that we can repair, or have repaired, ourselves. Consult advocacy organizations and wheelchair providers to provide guidance on which wheelchair components we can repair or have repaired by someone other than our wheelchair provider. This is also an opportunity for more businesses, such as bike shops, to expand into wheelchair repairs.

Thank you for your consideration on behalf of the 5.5 million wheelchair users in the United States.