Friday, April 23, 2010

The Federal Prosthetic and Custom Orthotic Parity Act (S. 3223)

From the ACA (I've bolded the especially important part):

The Federal Prosthetic and Custom Orthotic Parity Act (S. 3223) was introduced April 19 by Senators Olympia Snowe (R-ME) and Tom Harkin (D-IA). The Amputee Coalition of America (ACA) and the American Orthotic & Prosthetic Association (AOPA) have worked together with special help from the O&P Alliance over the past year to get the Senate bill introduced. In addition to the Alliance members and the ACA, there are more than 25 other nonprofit organizations with a stake in O&P patient care outcomes supporting the legislation.

The importance of federal parity and state 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." 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." This makes federal parity and state parity laws virtually indispensable, both in filling the gaps created by self-insured employers regulated by ERISA that are unaffected by state laws as well as reinforcing existing state laws that govern state-regulated insurance offerings. [KFG: To sum it up, KS would make a good home for those trying to dodge the state parity laws - then everyone could get the same treatment I get!]

The House P&O bill, HR 2575, was introduced last year by Representatives Rob Andrews (D-NJ) and George Miller (D-CA), who is also chair of the Education and Labor Committee.

We have strong bipartisan, chief sponsors of our Senate and House bills.

Senator Snowe said the following about the Senate bill:

"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. Providing more meaningful coverage is particularly essential for children, who may require more frequent replacements as they grow."

Senator Harkin added:

"Hundreds of thousands of Americans living with limb loss are currently required by their insurance companies to pay out-of-pocket for prosthetic devices that are integral to their daily lives. While most insurance companies cover prosthetics and orthotics, there are many instances where the benefits are arbitrarily capped or exclusions are imposed on those who need them. This legislation will require insurance companies to provide the same benefits for prosthetic devices as they do for other treatments, helping individuals with disabilities more fully participate in school, work and community activities."

Representative Andrews said the following about the House bill:

"By expanding coverage for prosthetic devices so that it is on par with other types of essential care, not only will amputees receive necessary treatment and experience better quality of life, but the healthcare industry as a whole will save money. Since prosthetics often dramatically decrease secondary health problems for those in need, the benefits of this coverage far outweigh the costs in the long run."

At this critical point, with a House bill and now a Senate bill both introduced, the ACA is gearing up grassroots activities and has a call to action for you to contact your member of Congress and ask him/her to sign as a cosponsor of the bill.

Saturday, April 10, 2010

Two things

I'll admit I've not spent much time here lately but two things caught my eye this week. First, there's an interesting and detailed summary of what it took to get prosthetic parity - not true parity, but a compromise - through Virginia. If you're interested, you can read it here: click me

This paragraph hit home: One of the reasons for the Advisory Commission's recommendation was the extremely positive report prepared by the Joint Legislative Audit and Review Commission. The JLARC report cited among other things 1) it was a reasonable presumption that amputees deserved to receive reimbursement from their health insurance for prosthetic care, 2) amputees who received the prosthetic care they needed were likely to return to life as productive members of society which could in turn save the state's social assistance programs, 3) the projected cost for the proposed coverage would be about .24 cents per month.

It is a very frank report and brings home why I cannot single handedly bring prosthetic parity to KS.  Nevermind that niggly detail, you know, the fact that I don't live in KS. Apparently I'm the only person working for KS who can't get insurance coverage for their prosthetic. Hmmm...who knew?

Then there's this especially hard hitting essay by Jothy Rosenberg about the indignity of going through airport security. It had my stomach tied up in knots by the time I was done reading. I've experienced the same embarassment and humiliation in airports and try to laugh it off. Ha-ha! Isn't it funny being an amputee and stripping down for the Looky-Lu's! There's nothing more fun than being the freak in the freak-show! Well, it isn't funny and it wears a body down. Between the humilation of baring your soul begging for a leg to stand on and baring your butt in airport security to total strangers it's more than I can stomach anymore.

Unless I find some new motivation or inspiration, I'm taking a breather.