Federal Legislation
Prosthetic Parity Now - Insurance Fairness for Amputees
On April 8, 2011, Senators Olympia Snowe (R-ME) and Tom Harkin (D-IA) introduced S.773, the Insurance Fairness for Amputees Act, which in previous Congresses was titled the Prosthetic and Custom Orthotic Parity Act. S.773 would require plans that cover orthotic and prosthetic services to provide those benefits at the same level as other surgical and medical benefits provided under a private health plan, with no separate caps, arbitrary exclusions, or lifetime limits for O&P care. The bill does not mandate coverage, however it is a good step to eliminating the caps and restrictions placed on prosthetics by many insurance companies. Similar legislation is expected to be reintroduced in the House of Representatives.
Orthotic & Prosthetic Coverage - Assembly Bill A1011 & Senate Bill S502
Senate Bill S502 passed on Thursday January 3rd, 2008
by a vote of Yes {33} No {0} Not Voting {7}and on January 7th, 2008 it was
substituted for A1011 on the Assembly floor so that an added amendment to
include NJ state workers would be in the final bill. S502 was successfully
passed the Assembly by a vote of Yes {70} No {8} Not Voting {2} Abstains {0}.
A
January 15th press release, states that Governor Jon Corzine signed S502 on
Sunday January 13th.
TRENTON - Governor Jon S. Corzine signed the following bills into law on Sunday, January 13, with related statements:
S-502/A-1011 w/Statement (Gill/Prieto, Stack, Cohen, Panter) – Requires health benefits coverage by health insurers and SHBP for orthotic and prosthetic appliances and provides reimbursement therefore.
“I commend the sponsors of Senate Bill No. 502 (First Reprint), which I signed today, for recognizing the importance of making sure that persons in need of orthotic or prosthetic appliances obtain them.
“While I have signed this measure in light of the critical nature of the issue for persons who need these appliances, I do have several concerns about elements of the bill which would have led me to conditionally veto the bill had it been presented to me in other circumstances. First, I have a general concern with bills that mandate specific insurance coverage. These bills deal piecemeal with issues of cost and coverage that might better be addressed more comprehensively. In that regard, I commend the work of the New Jersey Mandated Health Insurance Advisory Commission, and I will continue to read its reports with interest.
On April 13th, 2008
Bill S502 becomes law.
Link PDF of
the New Law
The new law provides coverage for Orthotics &
Prosthetics at the levels specified by Medicare to policies written or
renewed in New Jersey on or after April 13th. Therefore if your insurance is
from a company based in New Jersey, you will be covered when your policy is
renewed. For example if your companies insurance coverage is from January to
January then your coverage will not take effect until January 2009.
There are policies that are not required to add this coverage; If you are working for a company that is not based in New Jersey and they are self insured or their policy is written in the state where they are based the law does not apply.
AMPS IN ACTION Members are pictured below in Trenton on January 7th with Senator Nia Gill (senate bill sponsor) & Nancy Pinkin (form the lobby firm MBI GluckShaw)
Pictured above from left to right; Nancy Pinkin, Susan Lazarchick, Senator Nia Gill, Rodger Kearns (in the back), Dennis ODonnell, Bill Wagner and Mickey Nespol