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This is a political request for Texans, particularly for those who live in Denton/North Richland Hills/Flower Mound/Grapevine area.
There is a health care bill in the works in Austin right now that has an amendment that would help me and my fellow amputees. It addresses the practice where insurance companies say they cover prosthetics, but when the patient loses a limb and looks into the details often they find out,
(1) There is an unreasonably low cap on prosthetic components, lower than other comparable medical services, OR
(2) There is only coverage for one prosthesis in a lifetime, OR
(3) There is only coverage for components that are decades-old technology. Like walking on a 1967 Impala.
I have been fighting my insurance company since January for them to pay for a knee repair (I am currently on a "loaner" knee generously provided by my prosthetist). My problem is that I am on new technology. (which so happens to be the same as that given wounded soldiers at Walter Reed). Their policy leads to the only solution being that I get an entire new leg with old technology, the kind I had until 2002. I fell far more frequently on the old style and it required more effort to use.
This law will directly address my issue and similar ones I and many others have faced. It holds insurance companies to their word to "cover prothetics" in a meaningful way so consumers are not surpised to find out what they were (not) paying for. It defines prosthetic coverage to be the same as Medicare standard and gives doctors the authority to discern which components are necessary. Similar bi-partisan legislation has passed in Colorado, California, NH, and a few other states.
The House version passed with this amendment, but the Senate passed the bill before it was added. A joint committee is meeting (likely today or tomorrow) to hammer out the differences before sending it to the governor. The joint committee chair (and author of the original bill without the ammendment) is Sen Jane Nelson.
If you live in Texas, particularly in her district, and are behind this amendment, it would help if you simply called her office (512 463-0112) and tell the aid who answers that you urge Sen Nelson to concur to ammendment#16 of SB23.
Posted by Greg at May 24, 2007 11:35 AM | Comments (3)