Revision: Jan. 5, 2023, 12:01 p.m.
2023 SESSION
23-1041.0
05/04
SENATE BILL [bill number]
AN ACT relative to insurance coverage for prosthetic and orthotic devices.
SPONSORS: [sponsors]
COMMITTEE: [committee]
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ANALYSIS
This bill requires health insurance providers to cover prosthetic and orthotic devices under terms comparable to coverage for such devices under federal Medicaid laws for the aged and disabled.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
23-1041.0
05/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Three
AN ACT relative to insurance coverage for prosthetic and orthotic devices.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Accident and Health Insurance; Coverage for Prosthetic and Orthotic Devices; Individual Coverage. Amend RSA 415 by inserting after section 6-a1 the following new section:
415:6-bb Coverage for Prosthetic and Orthotic Devices. Each insurer that issues or renews any individual policy, plan or contract of accident or health insurance providing benefits for medical or hospital expenses shall provide to persons covered by such insurance, who are residents of this state, coverage for prosthetic and orthotic devices that, at a minimum, equals payment for prosthetic and orthotic devices provided under federal laws and regulations for the aged and disabled pursuant to 42 United States Code Sections 1395k, 1395l, and 1395m and 42 Code of Federal Regulations Sections 414.202, 414.210, 414.228, and 410.100. Covered benefits shall be provided for a prosthetic or orthotic device that adequately meets the medical needs of the enrollee, as determined by the enrollee's provider. With respect to an enrollee under 18 years of age, the covered benefit shall be for a prosthetic or orthotic device designed to maximize the enrollee’s ability to ambulate, run, bike and swim and to maximize upper limb function.
2 New Section; Accident and Health Insurance; Coverage for Prosthetic and Orthotic Devices; Group. Amend RSA 415 by inserting after section 18-ee the following new section:
415:18-ff Coverage for Prosthetic and Orthotic Devices. Each insurer that issues or renews a policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses shall provide to persons covered by such insurance, who are residents of this state, coverage for prosthetic and orthotic devices that, at a minimum, equals payment for prosthetic and orthotic devices provided under federal laws and regulations for the aged and disabled pursuant to 42 United States Code Sections 1395k, 1395l, and 1395m and 42 Code of Federal Regulations Sections 414.202, 414.210, 414.228, and 410.100. Covered benefits shall be provided for a prosthetic or orthotic device that adequately meets the medical needs of the enrollee, as determined by the enrollee's provider. With respect to an enrollee under 18 years of age, the covered benefit shall be for a prosthetic or orthotic device designed to maximize the enrollee’s ability to ambulate, run, bike and swim and to maximize upper limb function.
3 Health Services Corporations; Applicable Statutes. Amend RSA 420-A:2 to read as follows:
420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:6-u, RSA 415:6-v, RSA 415:6-w, RSA 415:6-x, RSA 415:6-y, RSA 415:6-z, RSA 415:6-a1, RSA 415:6-bb, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-i, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:18-z, RSA 415:18-aa, RSA 415:18-bb, RSA 415:18-cc, RSA 415:18-dd, RSA 415:18-ee, RSA 415:18-ff, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.
4 Health Maintenance Organizations; Statutory Construction. Amend RSA 420-B:20, III to read as follows:
III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:6-u, RSA 415:6-v, RSA 415:6-w, RSA 415:6-x, RSA 415:6-y, RSA 415:6-z, RSA 415:6-a1, RSA 415:6-bb, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-i, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:18-z, RSA 415:18-aa, RSA 415:18-bb, RSA 415:18-cc, RSA 415:18-dd, RSA 415:18-ee, RSA 415:18-ff, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.
5 Effective Date. This act shall take effect 60 days after its passage.