Prosthetic & Custom Orthotic Device Coverage
The bill will have a significant impact on state healthcare laws, particularly around disability rights and nondiscrimination. By defining prosthetic and orthotic devices as essential habilitative or rehabilitative benefits, the bill seeks to assure that individuals with disabilities, including limb loss or absence, will receive equitable coverage that aligns with their medical needs. Additionally, the requirements for insurance companies to apply nondiscriminatory practices during utilization reviews will prevent unfair treatment of insured individuals based on their disability.
House Bill 131 aims to enhance coverage for prosthetic and custom orthotic devices under health insurance plans in New Mexico. By enacting new provisions under the Health Care Purchasing Act and the Insurance Code, the bill mandates that all group health plans provide coverage for prosthetics and custom orthotics equivalent to that of Medicare. The intent is to ensure that individuals requiring these devices receive comprehensive coverage without unnecessary limitations.
The general sentiment surrounding HB 131 appears to be positive. Legislators and advocacy groups have expressed support for the bill, viewing it as a crucial step toward ensuring better access to necessary medical devices for those affected by disabilities. The bill aims to eliminate existing disparities in coverage and promote equal access to essential health benefits, fostering a more inclusive healthcare environment for all state residents.
Despite the overall positive sentiment, there may be points of contention related to how insurers implement these new coverage requirements. Some stakeholders are concerned about the potential for increased costs for insurers, which might lead to higher premiums for other policyholders. Furthermore, specifics regarding the criteria for determining medical necessity and the adequacy of provider networks may also become areas of debate as the bill progresses.