A Virginia bill designed to ensure fair insurance coverage for prosthetics and custom orthotic bracing was signed into law by Governor Tim Kaine on June 16. The bill, known as the Prosthetic Parity Act, requires insurers that cover prosthetic care to remove special caps and exemptions placed on prosthetic and orthopedic care.
Senate Bill 1116 was introduced by state senator Patricia Ticer (D), with delegates John O’Bannon (D) and Lee Ware (R) sponsoring it in the Virginia House of Representatives. It was passed in the Senate by a vote of 33-7 on February 3. It was then passed in the House unanimously, 99-0, on February 24. Sponsorship of the bills was bipartisan.
“Thanks to the leadership of the Virginia General Assembly and Governor Kaine, people with limb loss in Virginia can now get the care they need to get back to work and live independent, productive lives,” said Morgan Sheets, national advocacy director for the Amputee Coalition of America (ACA). “Spread across the insurance pool, the cost of prosthetic care is less than a dollar per month. Because of the lack of productivity caused by inadequate prosthetic care, the cost to the healthcare system in the long run of not providing prosthetic care far exceeds that of providing it.”
Seven states (Arkansas, Connecticut, Iowa, Maryland, Missouri, Texas, and Virginia) have already passed prosthetic parity legislation this year. These states join the 11 other states (California, Colorado, Indiana, Lousiana, Maine, Massachusetts, New Hampshire, New Jersey, Oregon, Rhode Island, and Vermont) that have previously enacted laws. The ACA is now working with activists throughout the country to advance similar state legislation. Additionally, the nonprofit organization is working on a federal prosthetic-and-orthotic parity bill that has been introduced in the U.S. House of Representatives as H.R. 2575 and to re-introduce a bill in the Senate.
In 2007, when Virginia resident Susan Bailey became infected at the age of 23 with E. coli bacteria that ultimately resulted in the amputation of both her legs, Virginia didn’t have a law ensuring that she would receive meaningful prosthetic care. Because no law was in place, her insurance company denied her the prosthetic legs her doctor recommended. Instead, Bailey was given prostheses that didn’t allow her to walk up and down stairs, let alone keep up with her two children. Susan had been paying her insurance premiums and expected to be covered adequately to allow her to get her mobility back.
“We are fighting for people like Susan Bailey and even for those people who are not aware of their lack of coverage,” Sheets said, “but it’s a difficult battle. Insurance companies have a powerful voice, and the Amputee Coalition and our citizen lobbyists are like David taking on Goliath. Still, with the support of those like Governor Kaine and the Virginia General Assembly, we believe that we can help win this victory for American families.”
