Oklahoma § 56-1012.2 - Definitions

§ 56-1012.2. Definitions

As used in the Commitment to Care for People with Complex

Physical Disabilities Act:

1. "Complex physical disability" means a diagnosis or medical

condition that results in significant physical impairment and/or

functional limitation. Such term shall include, but not be limited

to, individuals with spinal cord injury, traumatic brain injury,

cerebral palsy, muscular dystrophy, spina bifida, osteogenesis

imperfecta, arthrogryposis, amyotrophic lateral sclerosis, multiple

sclerosis, demyelinating disease, myelopathy, myopathy, progressive

muscular atrophy, anterior horn cell disease, post-polio syndrome,

cerebellar degeneration, dystonia, Huntington's disease,

Oklahoma Statutes - Title 56. Poor Persons

spinocerebellar disease, and certain types of amputation, paralysis,

or paresis that result in significant physical impairment and/or

functional limitation. The term "complex physical disability" does

not negate the requirement that an individual meet medical necessity

requirements under Oklahoma Health Care Authority rules to qualify

for receiving complex rehabilitation technology;

2. "Complex rehabilitation technology" (CRT) means items

classified within the Medicaid program as of January 1, 2013, as

durable medical equipment 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. Such items shall include, but not be limited to, complex

rehabilitation manual and power wheelchairs and options/accessories,

adaptive seating and positioning items and options/accessories, and

other specialized equipment such as standing frames and gait

trainers and options/accessories;

3. "Employee" means a person whose taxes are withheld by a

qualified CRT supplier and reported to the Internal Revenue Service;

4. "Healthcare Common Procedure Coding System (HCPCS)" means

the billing codes used by Medicare and overseen by the federal

Centers for Medicare and Medicaid Services that are based on the

current procedural technology codes developed by the American

Medical Association;

5. "Individually configured" means a device has a combination

of sizes, features, adjustments, or modifications that a qualified

complex rehabilitation technology supplier can customize to the

specific individual by measuring, fitting, programming, adjusting,

or adapting the device as appropriate so that the device is

consistent with an assessment or evaluation of the individual by a

qualified health care professional and consistent with the

individual's medical condition, physical and functional needs and

capacities, body size, period of need, and intended use;

6. "Qualified complex rehabilitation technology professional"

means an individual who is certified as an Assistive Technology

Professional (ATP) by the Rehabilitation Engineering and Assistive

Technology Society of North America (RESNA);

7. "Qualified complex rehabilitation technology supplier" means

a company or entity that:

a.

is accredited by a recognized accrediting organization

as a supplier of CRT,

b.

is an enrolled Medicare supplier and meets the

supplier and quality standards established for durable

medical equipment suppliers, including those for CRT,

under the Medicare program,

c.

employs as a W-2 employee at least one qualified CRT

professional for each location to:

Oklahoma Statutes - Title 56. Poor Persons

(1)

analyze the needs and capacities of the complexneeds patient in consultation with qualified

heath care professionals,

(2) participate in the selection of appropriate CRT

for such needs and capacities, and

(3) provide technology-related training in the proper

use of the CRT,

d.

requires a qualified complex rehabilitation technology

professional be physically present for the evaluation

and determination of appropriate CRT,

e.

has the capability to provide service and repair by

qualified technicians for all CRT it sells, and

f.

provides written information to the complex-needs

patient prior to ordering CRT as to how the complexneeds patient may receive service and repair; and

8. "Qualified health care professional" means a health care

professional licensed by the State Department of Health who has no

financial relationship with a qualified complex rehabilitation

technology supplier. Qualified health care professional includes,

but is not limited to:

a.

a licensed physician,

b.

a licensed physical therapist,

c.

a licensed occupational therapist, or

d.

other licensed health care professional who performs

specialty evaluations within the professional's scope

of practice.

Added by Laws 2015, c. 324, § 3, eff. Nov. 1, 2015.