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Delaware Governor Markell Signs Prosthetic Parity Act into Law

Monday, August 29, 2011   (0 Comments)
Posted by: Brian Lagana
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Delaware Governor Markell Signs Prosthetic Parity Act into Law

On August 15, 2011, Governor Jack Markell signed House Bill 76 to make Delaware the 20th state to enact "prosthetic parity” legislation, putting orthotics and prosthetics on par with other medical benefits. Delaware joins New Jersey, Maryland, Virginia, Colorado, Maine, New Hampshire, Rhode Island, Massachusetts, California, Oregon, Indiana, Vermont, Louisiana, Arkansas, Iowa, Texas, Missouri, Illinois, and Utah in requiring all health insurance policies to provide orthotic and prosthetic devices at a reimbursement rate equal to the Federal reimbursement rate for Medicare and Medicaid. Previously, coverage varied widely among insurers with some policies limiting individuals—including growing children—to one prosthetic for their lifetime.

HB 76 defines an orthosis as a custom fabricated brace or support that is designed based on medical necessity. Orthosis does not include prefabricated or direct-formed orthotic devices or any of the following assistive technology devices: commercially available knee orthoses used following injury or surgery; spastic muscle-tone inhibiting orthoses; upper extremity adaptive equipment; finger splints; hand splints; wrist gauntlets; face masks used following burns; wheelchair seating that is an integral part of the wheelchair and not worn by the patient independent of the wheelchair; fabric or elastic supports; corsets; low-temperature formed plastic splints; trusses; elastic hose; canes; crutches; cervical collars; dental appliances; and any other similar devices, as determined Secretary of the Department of Heath and Social Services, commonly carried in stock by a pharmacy, department store, or surgical supply facility.

The new requirements go into effect January 1, 2012.

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