3 minute read
State By State
by AOPA
Coverage Concerns
Activity in several states focuses on legislation mandating O&P coverage
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Each month, State By State features news from O&P professionals about the most important state and local issues affecting their businesses and the patients they serve. This section includes information about medical policy updates, fee schedule adjustments, state association announcements, and more. These reports are accurate at press time, but constantly evolve. For up-to-date information about what is happening in your state, visit the Co-OP at www.AOPAnet.org/resources/co-op.
STATE POLICYMAKERS ACROSS THE country have recently shown their support for mandatory coverage of orthotic and prosthetic devices. AOPA is tracking several developments on the respective state pages of the AOPA Co-OP, with highlights below.
Arizona
Arizona House Bill 2302 has been introduced in the state’s House of Representatives. HB 2302 requires that insurance providers in the state provide coverage for orthotic and prosthetic devices that is at least equivalent to the coverage currently provided under Medicare. This bill has an identical predecessor, HB 2094, which was introduced in the 2021 legislative session but not passed; in Arizona, bills do not carry over from one session to the next.
New York
New York Senate Bill 03649, which requires mandatory health insurance coverage of prosthetic devices for veterans injured while on active duty, has been referred to the State Senate’s Insurance Committee. Coverage under SB 03649 includes repair and replacement in cases of normal wear and tear, new fitting needs, or changes in a patient’s medical condition.
Virginia
Companion bills HB 925 and SB 405 have seen considerable movement and overwhelming support in the Virginia legislature since their introduction earlier this year. Recommended by the Virginia Health Insurance Reform Commission, HB 925 and SB 405 would revise the existing code of Virginia to require private and employee-sponsored insurance plans to provide coverage for prosthetic care, repealing the existing requirement that coverage for prosthetic devices only be offered and made available. Each bill has passed through both the state Senate and House of Delegates, and will now be reconciled before moving to the governor’s desk for his signature. AOPA testified in favor a previous version of this legislation, HB 503, in January 2020.
Washington
Washington House Bill 1427 has been reintroduced in the state’s House of Representatives after its introduction in early 2021 (in Washington, bills can carry over from sessions in odd-numbered years to sessions in even-numbered years). Similar to Arizona HB 2302, Washington HB 1427 states that health plans issued on or after Jan. 1, 2022, must provide coverage for orthotic and prosthetic devices that are at least equivalent to Medicare. As of this writing, the bill has eight Republican and nine Democratic cosponsors.
Member Resource Alert
AOPA has invested in a resource that allows us to track legislative and regulatory activity related to O&P in every state. We will be updating the state pages on the AOPA Co-OP with alerts as they arise.
Submit Your State News
To submit an update for publication in the State by State department of O&P Almanac, email awhite@AOPAnet.org.
SEPTEMBER 28-OCTOBER 1 San Antonio
Mark Your Calendars!
Join us September 28-October 1, 2022, for an ideal combination of top-notch education and entertainment at the 105th AOPA National Assembly in San Antonio, TX.
