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Prosthetics coverage

Published (3/18/2010)
By Lauren Radomski
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Aaron Holm was helping a co-worker change a tire on the side of Interstate 394 in Wayzata in January 2007 when he was hit from behind by a vehicle traveling at 55 mph. The incident cost him both of his legs.

Seven months later, Holm was back at work with the help of prosthetic legs. He credits his “quick and successful recovery” to the fact that his legs were covered by workers compensation. Yet others in the limb-loss community have a harder time getting insurance coverage for their prosthetics, he said.

Rep. Maria Ruud (DFL-Minnetonka) sponsors a bill intended to help those people. As amended, HF2379 would require health plans to cover orthotic and prosthetic devices to the same extent they are covered under Medicare Part B. Coverage would be limited to devices deemed medically necessary by a health care provider, and covered repairs would need to meet certain specifications.

Ruud’s bill was approved by the House Health Care and Human Services Policy and Oversight Committee March 17 and sent to the House Commerce and Labor Committee. A companion, SF2139, sponsored by Sen. John Marty (DFL-Roseville), awaits action by the Senate Health and Human Services Budget Division.

Without adequate insurance coverage, people who have lost limbs due to injury, surgery or disease are forced to pay out-of-pocket or rely on state programs, said Rick Miller, president of the Minnesota Society of Orthotists, Prosthetists and Pedorthists. Lack of proper care upfront can also lead to more expensive health problems in the future.

While the amended bill reflects concessions by supporters, the Minnesota Council of Health Plans remains opposed to the legislation because it represents a mandated benefit, said council representative Geoff Bartsh. Also, many plans already cover prosthetics under language similar to that of the bill.

Rep. Steve Gottwalt (R-St. Cloud) unsuccessfully made a motion to table the bill, saying committee members needed more time to collect information on the coverage of specific plans before moving the legislation.

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