An Act to improve outcomes for persons with limb loss and limb difference
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Overview
This bill aims to improve healthcare outcomes for individuals with limb loss or limb difference in Massachusetts. It clarifies definitions related to orthotics and prosthetics, expands coverage for specialized prosthetic devices used for physical activities, and ensures nondiscriminatory coverage decisions. The bill also addresses coverage requirements for MassHealth members and establishes standards for provider networks to ensure access to necessary care and devices.
Key provisions
- Defines ‘orthosis’ and ‘prosthetic device’ for clarity.
- Expands coverage for prosthetic and orthotic devices designed for specific physical activities, including those for showering and bathing.
- Requires insurers to provide nondiscriminatory coverage for habilitative and rehabilitative benefits, including prosthetics and orthotics.
- Ensures access to medically necessary clinical care and prosthetic/orthotic devices from at least two providers in the managed care network.
- Provides for out-of-network reimbursement at a mutually agreed-upon rate.
- Allows for replacement of prosthetic or orthotic devices without regard to continuous use or useful lifetime, based on a healthcare provider’s determination of necessity.
- Establishes prescription requirements for MassHealth members seeking orthotic or prosthetic coverage.
- Extends coverage for prosthetic and orthotic devices to MassHealth members under similar terms as other durable medical equipment.
Bill text
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Sponsors
Official sponsors from legislative records.
6 on record
Primary sponsor
Joint Committee on Financial Services
Cosponsors
Daniel Cahill
Jacob R. Oliveira
Joanne M. Comerford
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