The Amputee Coalition of America (ACA) and the American Orthotic &
Prosthetic Association (AOPA) hail the introduction of the “Prosthetics
and Custom Orthotics Parity Act of 2010” in the U.S. Senate as a major
step toward ensuring that Americans with disabilities have fair access to the
mobility devices they need to support their families and live full, active
lives. Such devices include artificial arms and legs for amputees and custom
orthotic devices for people challenged by cerebral palsy, muscular dystrophy,
multiple sclerosis, spina bifida and other diseases.
This legislation recognizes the importance of mobility to overall health
and bans employers and insurers from imposing stricter limits on insurance
coverage for prosthetic arms and legs and custom orthotic devices than those
set for other essential medical care. This bipartisan bill, S 3223, was
introduced on April 19 by senators Olympia Snowe (R-ME) and Tom Harkin (D-IA).
“Our legislation will ensure that group health plans treat coverage
of such prosthetics and custom orthotics on par with other essential medical
care covered by health insurance,” Snowe said in a news release.
“Providing more meaningful coverage is particularly essential for children
who may require more frequent replacements as they grow.”
S 3223 will remove lifetime caps and exemptions that insurance companies
often place on prosthetic and orthotic care, which reduce benefits to such a
level that the average person can not afford a prosthesis or complex bracing
device. In some cases, these companies have even eliminated coverage completely
for artificial limbs.
“Since an adult amputee will need a replacement prosthesis every 5
years and children even more frequently as they grow, it is absurd to expect
amputees to use only one prosthesis per lifetime,” Kendra Calhoun,
president and chief executive officer of the ACA, explained. “No one would
expect a person to wear a single pair of shoes their entire life, and
prosthetic devices should be no different. People pay their monthly health
insurance premiums and expect their coverage to take care of catastrophic
situations. Arms and legs are not luxury items. Mobility is a serious issue for
amputees.”
The importance of federal parity legislation has grown dramatically with
the passage of the recent healthcare reform law, which permits health insurers
to sell across state lines under “health insurance compacts,” AOPA
executive director Thomas Fise explained.
“These multi-state arrangements allow the insurer to select the
lowest common regulatory denominator. It is feared that states without parity
laws would often be the insurer’s regulatory venue of first choice. This
choice would in effect rescind or override any parity laws that may have been
passed in other states served by the health insurance compact. That makes this
federal parity law virtually indispensable both in filling in the gaps created
as to Employee Retirement Income Security Act plans that are unaffected by
state laws as well as reinforcing existing state laws most crucial to preserve
patient care that is not subject to lifetime limits or other arbitrary benefit
caps.”
