Amends TCA Title 56 and Title 71.

Present law defines "complex rehabilitation technology" to mean items classified within medicare as group 3, group 4, or group 5 power wheelchairs and manual wheelchairs with certain billing codes, and options and accessories related to any of such items. This bill prohibits health insurers that offer a health benefit plan that provides coverage of complex rehabilitation technology from considering the location where the complex rehabilitation technology will be used when determining medical necessity. This bill requires such health insurers to offer covered persons a prior authorization process that reviews billable codes and provides coverage determinations for complex rehabilitation technology. If a health insurer notifies a person who is covered under a policy or contract for a health benefit plan that includes complex rehabilitation technology benefits and coverage that complex rehabilitation technology equipment that was approved in a prior authorization will be fully funded under the health benefit plan, then this bill requires the health insurer: (1) To continue to cover the covered person until the time of delivery of the complex rehabilitation technology; and (2) Pay 100 percent of the cost of the complex rehabilitation technology. This bill prohibits a health insurer that is subject to the requirements of (1) and (2) from seeking payment or reimbursement from the covered person, a complex rehabilitation technology vendor, or another party involved with the sale or delivery of the complex rehabilitation technology. ON MARCH 28, 2022, THE SENATE ADOPTED AMENDMENT #1 AND PASSED SENATE BILL 2134, AS AMENDED. AMENDMENT #1 specifies, in regard to this bill's requirements for a health insurer that notifies a person who is covered under a policy or contract for a health benefit plan that includes complex rehabilitation technology benefits and coverage that complex rehabilitation technology equipment that was approved in a prior authorization will be fully funded under the health benefit plan, that the requirements apply as long as the person remains covered under the policy or contract at the time the complex rehabilitation technology is delivered to the person. In regard to the particular requirements, described above in the bill summary in (1) and (2), this amendment rewrites the requirements to instead require the health insurer to pay 100 percent of the amount approved in the prior authorization, subject to applicable copayment, coinsurance, or deductible requirements as provided in the policy. ON APRIL 7, 2022, THE HOUSE SUBSTITUTED SENATE BILL 2134 FOR HOUSE BILL 2048, ADOPTED AMENDMENT #1, AND PASSED SENATE BILL 2134, AS AMENDED. AMENDMENT #1 specifies that this bill does not require a health insurer to offer coverage for complex rehabilitation technology in a health benefit plan.