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Prosthetic Coverage Legislation: A Tool Kit for State Organizers

THE CASE FOR PARITY

Today, people with limb loss face more challenges than ever before. Growing healthcare costs and cuts by insurers’ and employers’ coverage of healthcare are putting increasing pressure on working families. This challenge is even more critical for people with limb loss. As benefits are cut, the very prostheses that they need to continue to participate in school activities, be an integral part of the work force and provide for their families are in jeopardy.

People living with the absence or loss of a limb face daunting obstacles when attempting to obtain appropriate prosthetic care. Some third-party payers place annual or lifetime caps on prosthetic devices. Others eliminate coverage altogether. These factors may very well prevent people with limb loss from living productive lives, lead to poor rehabilitation outcomes, and place amputees at risk for dangerous and costly secondary conditions.

Chronic secondary conditions such as depression, obesity and cardiovascular disease can lead to additional amputation. Each of these costly, devastating conditions exacts a tremendous emotional and economic toll on society, but they can be prevented by providing appropriate technology, support and education.

BUILDING A NATIONAL MOVEMENT FOR PARITY

The Amputee Coalition of America ( ACA) has assumed the challenge to address and improve prosthetic access for all amputees in the U.S., at both state and federal levels. The ACA is working to bring together patients and providers, trade groups and manufacturers through the Action Plan for People with Limb Loss (APPLL) to aggressively reverse these negative reimbursement trends and stem the emergency threats that could further erode coverage and access for prosthetic care.

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