October 2019
Insurance Fairness Bill
In general, IFA legislation provides for the following:
a. All individual and group health insurance policies providing coverage for hospital, medical or surgical expenses shall provide coverage for benefits for prosthetics and orthotics that are at least equivalent to that currently provided by the federal Medicare program, and no less favorable than the terms and conditions for the medical and surgical benefits in the policy.
b. The policy shall cover the most appropriate device that is determined to be medically necessary by the treating physician to restore functionality to optimal levels.
c. The reimbursement rate for prosthetic and orthotic devices in all health plans must be at least equivalent to that currently provided by the federal Medicare program and no more restrictive than other benefits in the policy and shall be comparable to coverage of restorative internal devices without arbitrary caps or lifetime restrictions.
Full text of Model Bill Language can be found here:
https://3w568y1pmc7umeynn2o6c1my-wpengine.netdna-ssl.com/wp-content/uploads/2015/03/fair-insurance-for-amputees-model-bill.pdf
The Amputee Coalition first introduced AFI legislation in 2019, but the bill did not make it out of the House Health and Family Services Committee
(copy of bill can be found here: https://apps.legislature.ky.gov/record/19rs/hb361.html).
The Amputee Coalition is looking for advocates to support its effort to pass AFI legislation.
(see https://www.amputee-coalition.org/advocacy-awareness/state-issues/kentucky/).
In general, IFA legislation provides for the following:
a. All individual and group health insurance policies providing coverage for hospital, medical or surgical expenses shall provide coverage for benefits for prosthetics and orthotics that are at least equivalent to that currently provided by the federal Medicare program, and no less favorable than the terms and conditions for the medical and surgical benefits in the policy.
b. The policy shall cover the most appropriate device that is determined to be medically necessary by the treating physician to restore functionality to optimal levels.
c. The reimbursement rate for prosthetic and orthotic devices in all health plans must be at least equivalent to that currently provided by the federal Medicare program and no more restrictive than other benefits in the policy and shall be comparable to coverage of restorative internal devices without arbitrary caps or lifetime restrictions.
Full text of Model Bill Language can be found here:
https://3w568y1pmc7umeynn2o6c1my-wpengine.netdna-ssl.com/wp-content/uploads/2015/03/fair-insurance-for-amputees-model-bill.pdf
The Amputee Coalition first introduced AFI legislation in 2019, but the bill did not make it out of the House Health and Family Services Committee
(copy of bill can be found here: https://apps.legislature.ky.gov/record/19rs/hb361.html).
The Amputee Coalition is looking for advocates to support its effort to pass AFI legislation.
(see https://www.amputee-coalition.org/advocacy-awareness/state-issues/kentucky/).
03/27/2019 - House Bill 224 became law without Governor's Signature (KY Acts ch. 176)
Click here for more information.
Click here for more information.
