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H.R. 3020

Insurance Fairness for Amputees Act

Insurance Fairness for Amputees Act - Amends the Employee Retirement Income Security Act of 1974 (ERISA) and the Public Health Service Act to require a group health plan that provides medical and surgical benefits and also provides benefits for prosthetics and custom orthotics to offer such prosthetics and custom orthotics in the same manner as applicable to medical and surgical benefits. Prohibits separate financial requirements or more restrictive treatment limitations. Requires a health plan that does not provide coverage for benefits outside of a network to ensure that such provider network is adequate to ensure enrollee access to prosthetic and custom orthotic devices and related services provided by appropriately credentialed practitioners and accredited suppliers.

Allows limitation of coverage for required benefits for prosthetics and custom orthotics to the most appropriate device or component that meets the medical requirements of the patient. Requires benefits to include repair and replacement due to normal wear and tear, irreparable damage, a change in the patient's condition, or as otherwise determined appropriate by the treating physician.

Prohibits any annual or lifetime dollar limitation on benefits for prosthetics and custom orthotics unless such limitation applies in the aggregate to all benefits.

Referred to the Subcommittee on Health, Employment, Labor, and Pensions.

Rep. Dent, Charles W. [R-PA-15](R-PA)Sponsor
1 cosponsor1 D
1cosponsors3committees7actions9subjects
  • Introduced in HouseAug 2, 2013
  1. Committee

    Referred to the Subcommittee on Health, Employment, Labor, and Pensions.

  2. Committee

    Referred to the Subcommittee on Health.

  3. IntroReferralH11100

    Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

  4. IntroReferralH11100

    Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

  5. IntroReferralH11100

    Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

  6. IntroReferralIntro-H

    Introduced in House

  7. IntroReferral1000

    Introduced in House

Insurance Fairness for Amputees Act — Informed