Iowa residents who rely on wheelchairs through the state’s Medicaid program will no longer need a prescription or an in-person doctor’s visit to have their wheelchair repaired following a policy change by the Iowa Department of Health and Human Services.
State Representative Josh Turek, D-Council Bluffs, said in an interview Tuesday that the measure shows that engagement can make a difference. Previously, members of the Iowa Medicaid program had to obtain a prescription and make an appointment with a doctor to have their wheelchair repaired – a requirement that Turek said was unnecessary because wheelchair users were already prescribed the device when it was delivered.
“It was simply an unnecessary obstacle that caused tremendous harm and suffering to the disabled population and delayed the process of people even getting wheelchair repairs by weeks or months,” Turek said.
Those prescription-related delays left some Iowans with disabilities homebound for long periods of time because they didn’t have a working mobility device, he said.
Turek, who uses a wheelchair, sponsored a “right to repair” bill in the 2024 legislative session that would eliminate prescription and doctor-visit requirements for wheelchair repairs under Medicaid. Although the bill received unanimous support in the House, it was not debated in the Senate, he said.
Although the legislation did not advance, the measure was implemented anyway. As of July 1, the Iowa Department of Public Health no longer requires a prescription for wheelchair repairs.
“The Iowa Department of Health and Human Services is aware of concerns regarding obstacles and delays in repairing its members’ wheelchairs and is working to best assist our members,” health department officials wrote in a July 10 letter to medical equipment suppliers.
Turek linked the change in HHS administration policy to discussions during the legislative session. The repair delays due to the prescription requirement “really weren’t on the radar” of HHS, he said, but advocacy from lawmakers and members of the disability community prompted the State Department to act.
“To some people, that may not seem like much, but to the disabled population, that’s a huge change,” Turek said. “…That’s exactly what we should be doing as legislators: working on policies that improve people’s lives, improve Iowans’ lives. And secondly, this is a huge win that shows that advocacy and awareness can work. Because ultimately, we couldn’t get it passed at the legislative level, but thanks to the attention we brought to it and our advocacy, we were able to get it done.”
While prescription and in-person visit requirements have been lifted, wheelchair users in the state’s Medicaid program still need prior authorization for equipment repairs — pre-approval from the managed care organization (MCO) or private insurer that provides Medicaid coverage. That process can also take several weeks, according to Turek — time during which the Medicaid recipient cannot have the needed repair done.
“What will often end up happening is that the tradesman is there, the service provider is in-house, the (repair) equipment is there, the ability to do it, and then you say, ‘I’m sorry, but we have to wait until we get that permit,'” he said.
Turek said he plans to advocate in future meetings for ways to shorten the wait time for the repair process, such as requiring MCOs to respond to permit requests within seven to 10 days or removing the permit requirement for repairs costing less than $700.
“Many of the problems that happen to the disabled population are not born out of malice, but out of a complete lack of awareness and understanding,” he said. “So the more attention I can bring to Medicaid and the more we work together on this issue, the more likely we’ll be able to find lasting solutions like this. I hope we can find some legislative solutions, but ultimately I hope that just through advocacy for the disabled population, we can do more of this kind of thing where we can do it directly through policy change.”
