SB 595 - This act requires, by January 1, 2011, health carriers to provide coverage for certain prosthetic devices and related services and supplies that meet minimum standards as provided under the federal Medicare Program. "Prosthetic device" is defined as an artificial limb, device, or appliance designed to replace in whole or in part an arm, leg, or eye. Under the terms of the act, a health insurance carrier may require an insured to obtain prior authorization for any prosthetic device. The health carrier may impose co-payments and co-insurance requirements in accordance with Part B of the federal Medicare Fee-for-service Program. The health benefit plan must reimburse an insured for the devices at no less than the fee schedule amount under the federal Medicare reimbursement schedule. The coverage shall include repair services and replacement of prosthetics needed to restore or maintain the daily living or essential job-related activities. Certain health and life insurance polices are exempt from the provisions of the act. The provisions of this act are virtually identical to SB 320 (2009).
STEPHEN WITTE