An Act to create 609.865 and 632.895 (16g) of the statutes; Relating to: health insurance coverage of prosthetic limbs and custom orthotic braces. (FE)
Impact
This legislation primarily impacts statutes regarding health insurance and disability policies, aligning them more closely with requirements established under federal Medicare standards. It aims to ensure that such devices are accessible to those who need them, thereby enhancing the quality of life for individuals with limb loss or dysfunction. The bill underscores that coverage must be equivalent to what is provided under Medicare, meaning that it sets a legislative minimum for insurance policies regarding prosthetic devices.
Summary
Assembly Bill 1121 mandates that health insurance policies and self-insured governmental plans provide coverage for prosthetic limbs and custom orthotic braces when they are deemed medically necessary. This coverage ensures that individuals can participate in daily living activities, essential job-related tasks, or perform physical activities that promote their limb function. The bill specifies that the coverage includes not only the devices themselves but also necessary materials, components, and training for usage, as well as any reasonable repairs needed.
Contention
Notable points of contention likely revolve around the insurance industry's response to mandated coverage expansions and the potential financial implications for health plans. Discussions might focus on the balance between ensuring necessary medical support for individuals with disabilities while addressing the costs associated with wider insurance mandates. There may be concerns about how these regulations could affect premium rates for policyholders or the operational dynamics for managed care plans, particularly regarding provider access and reimbursement rates.
Crossfiled
An Act to create 609.865 and 632.895 (16g) of the statutes; Relating to: health insurance coverage of prosthetic limbs and custom orthotic braces. (FE)