HB 2100 -- Health Insurance Coverage for Prosthetic Devices

Sponsor:  Cooper (155)

This bill requires, by January 1, 2009, all health insurance
benefit plans 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.

A health insurance carrier:

(1)  May require an insured to obtain prior authorization for any
prosthetic device;

(2)  May impose co-payments and co-insurance requirements in
accordance with Part B of the federal Medicare Fee-for-service
Program; and

(3)  Must reimburse an insured for the devices at no less than
the fee schedule amount under the federal Medicare reimbursement
schedule.

The coverage benefits will:

(1)  Be limited to the most appropriate devices that adequately
meet the medical needs of the insured to perform activities of
daily living and essential job-related activities as determined
by his or her physician;

(2)  Include repair services and replacement of prosthetics
needed to restore or maintain the daily living or essential
job-related activities; and

(3)  Not impose any annual or lifetime benefit maximum for
prosthetic devices.

Certain health and life insurance polices are exempt from the
provisions of the bill.

Missouri House of Representatives
94th General Assembly, 2nd Regular Session
Last Updated October 15, 2008 at 3:11 pm