WASHINGTON—Legislation has been introduced in the Senate that would require group health plans to provide parity in coverage benefits for prosthetic devices for amputees.
The bill, S. 3517, introduced Friday by Sen. Olympia Snowe, R-Maine, and Tom Harkin, D-Iowa, would require employer-paid health insurance to treat coverage of prosthetic care and devices on par with other essential medical care devices covered by health insurance.
"It does not mandate coverage, but it does assure that when it is offered it is not so restricted or capped that it does not assure an amputee of the prosthetic care they require," Sen. Snowe said in a statement.
A similar bill, H.R. 5615, was introduced in the House of Representatives in March by Rep. Robert Andrews, D-N.J., with bipartisan support. The measure prevents group health plans from imposing any annual or lifetime dollar limits on benefits for prosthetic devices and components, unless such limits apply in the aggregate to all medical and surgical benefits. The House bill has not been acted on.
Coverage for prostheses varies widely, and a growing number of insurers are limiting coverage by imposing low dollar caps and restrictions, according to Amputee Coalition of America, the Knoxville, Tenn.-based advocacy group that has championed the legislation. Approximately 2 million individuals are affected by limb loss, according to ACA.
Prosthetic parity measures have passed in 11 states, most recently Louisiana and Vermont (BI, April 23).
For reprints of this story, please contact Lauren Melesio at 212-210-0707 or email lmelesio@crain.com
