This report originally appeared in the June 2010 issue of DOTmed Business News

In Delaware, House Bill 343, sponsored by Rep. Gerald Brady, is under consideration by the House Appropriations Committee. The bill would require prosthetic parity for the benefit of citizens who have experienced limb loss by requiring private insurers to match the federal government's reimbursement rate for prosthetic devices. A prosthesis is defined in the law as an artificial medical device that is not surgically implanted and that is used to replace a missing limb, appendage or other external human body part. Examples include artificial limbs, hands and feet.

According to the bill, as of 2007 more than 1.7 million people in America have experienced the loss of a limb and approximately 185,000 new amputations occur each year. The bill also states that prosthetic parity laws require health insurers to offer or provide coverage for prosthetic care equal to, and under terms no less favorable than, coverage offered for essential medical care.
Currently, 11 states offer such prosthetic parity laws. The states that have adopted the laws have not been subject to a significant increase in health insurance costs. The parity reduces spending on rehabilitation, future complications and secondary conditions associated with limb loss.

The bill would require individual health insurance contracts, plans or policies on or after Jan. 1, 2011 to provide coverage for benefits for orthotic and prosthetic devices equal to those benefits provided for under federal laws for health insurance for the aged and disabled. Prior authorization will be required. The covered benefits will be limited to the most appropriate model meeting the medical needs of the patient. Repair and replacement of orthotic or prosthetic devices would be covered.

More Industry Headlines