California Becomes Fifth State to Ensure Coverage

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By Morgan Sheets

California and Massachusetts are poised to become the fifth and sixth states to pass legislation requiring comprehensive prosthetic cov­erage.

AB2012 is awaiting Governor Schwar­zenegger's signature. Sponsored by Rep. Bill Emmerson, the bill mandates that insurance plans offering coverage for orthotic and prosthetic care must provide full coverage--without caps and co-pays that restrict access to prescribed devices.

Prior to passage, California law allowed health plans to simply "offer" coverage, but this ambiguous language led to severe reductions and limitations to coverage. AB2012 closes this loophole and ensures patients receive the care they need. It also mandates that O&P providers will have met a standard level of competency to fit and furnish these devices and services by being nationally certified.

We also are awaiting a signature from the governor of Massachusetts on a coverage bill. After several years of campaigning by groups like the Massachusetts Society for Orthotists and Prosthetists, H5256 was passed by both the House and Senate with strong support. The ACA is part of a state lobbying campaign to urge the governor to support this crucial legislation.

We hope Massachusetts and Cali­fornia will join Colorado, Maine, New Hampshire, and Rhode Island in providing parity.

A couple of states are still in play for the 2006 session. We are looking for a vote on A1011 on the Assembly floor in New Jersey.

A public hearing on HB2718, Penn­sylvania's prosthetic coverage bill will be held in the Health & Human Services Committee on October 10.

We have a lot to celebrate and many exciting opportunities just around the corner this fall.

Morgan Sheets is the national campaign director for ACAs APPLL initiative. She can be reached at APPLL@amputee-coalition.org