7/30/2008
NAAOP Letter To Congress In Support Of H.R. 5615, the Group Health Plan Prosthetics Parity Act
July 30, 2008
The Honorable Robert Andrews
The Honorable George Miller
The Honorable Todd Platts
The Honorable Mario Diaz-Balart
The Honorable Lincoln Diaz-Balart
United States House of Representatives
Washington, DC 20510
Dear Representatives Andrews, Miller, Platts, Diaz-Balart and Diaz-Balart:
The National Association for the Advancement of Orthotics and Prosthetics ("NAAOP") strongly supports H.R. 5615, the bipartisan Group Health Plan Prosthetics Parity Act of 2007. We thank you for your leadership on this important issue. NAAOP is a non-profit trade association dedicated to educating the public and promoting public policy that is in the interest of the orthotic and prosthetic ("O&P") patient and the providers who serve them.
More than 1,800,000 people in the United States live with limb loss, and every year, more than 130,000 people undergo amputation. The demand for prosthetic services continues to increase, not only from new amputees returning from combat abroad, but also from chronic disease at home. Diabetes, and the precursor to this chronic illness, obesity, are on the rise and are major contributors to amputation rates. As the "baby boom" generation continues to age, the incidence and prevalence rates of amputation will continue to increase significantly.
All too often, individuals requiring prosthetic care are denied coverage by their insurance plan or find that such coverage is inadequate to provide for their prosthetic needs. A recent poll conducted by the Amputee Coalition of America found that 24 percent of individuals with private health insurance had their prosthetic coverage reduced over the past three years. Without access to prosthetic care, quality of life is affected and it can be more difficult to return to work or participate in other activities. Restrictions in private insurance coverage shift the burden of prosthetic costs onto government programs such as Medicare and Medicaid.
Your legislation, H.R. 5615, promotes access to prosthetic care by requiring group health plans that offer coverage for prosthetics to provide that coverage under terms and conditions that are no less favorable than the terms and conditions provided for other medical and surgical benefits under the plan, including deductibles, coinsurance and copayments. In addition, coverage must include repair or replacement of prosthetic devices or components, and group health plans may not impose annual or lifetime limits on coverage unless such limits apply to other medical and surgical benefits.
This legislation also directs the Comptroller General of the United States ("GAO") to conduct a study on the impact of these new prosthetic parity provisions on access to care, quality of care, and the cost or savings generated by these provisions. NAAOP supports this study and looks forward to the valuable findings we expect it to contain.
The Group Health Plan Prosthetics Parity Act of 2007 will increase the quality of life for individuals with limb loss who require prosthetic care. We urge swift passage of this bill so that it may be signed into law this year. We thank you again for your leadership on this very important issue.
Sincerely,
Thomas Guth, CP
President
