Kerth Langeneckert: Trucker, Harley Enthusiast, Amputee

Kerth Langeneckert drives a truck for a living and still loves to ride his Harley Davidson, but in 2005, he was involved in a motorcycle accident that left his left leg badly broken. After surgery, he developed an infection and eventually had to undergo an above-the-knee amputation. He describes himself as “being in a state of depression” after he lost his leg. After his prosthetist Dan Luitjohan made him a new leg, Kerth said, “It’s just good to finally get up out of a wheelchair or crutches and stand on two legs and actually walk on my own.”

Langeneckert’s insurance at the time of his amputation paid for his first prosthesis. His new leg even enabled him to go back to work driving a truck with a manual clutch. After two years, however, his residual limb has shrunk, causing the socket of his prosthesis, the part that fits over his leg, no longer to fit properly.

A poorly fitting prosthesis is very painful and can sometimes lead to blisters, infection, and sometimes new amputations or death. Prosthetic limbs do show wear and most amputees experience some change in the size of their residual limbs and require new sockets from time to time. And a new prosthesis may be required, sometimes every 3 to 5 years.

The private insurance Kerth has with this new job won’t pay for him to get a socket replacement so his leg will fit. How was his employer, a trucking company, supposed to know that $2500 is an unreasonable cap on annual prosthetic coverage? Parity legislation is needed in Missouri so working amputees like Kerth Langeneckert can continue to live with the quality of life they deserve.

The Fight for Prosthetic Parity Heats Up in Missouri and Across the Nation

Do working Americans who pay for health insurance deserve to walk again and return to work if a medical condition lands them with limb loss?

That’s the question before twenty-three state legislatures across the country. Parity laws require health insurance companies to cover prosthetic limbs when deemed medically necessary by a physician, without setting unrealistic price caps or once-in-a-lifetime clauses. When insurers fulfill their obligations, amputees are much less likely to depend on government services like Medicaid.Medicare, Medicaid, and the Department of Veteran Affairs already provide the coverage required by parity laws. But a movement to cut healthcare costs has led some private insurers here in Missouri to place annual limits on prosthetic coverage, ranging from $1500 to $4000, not quite half the cost of a below-knee prosthesis.

Insurance companies and government payers have always used provider contracts with companies like P&O Care to dictate how much they will pay for different types of prosthetics. But these new caps are imposed directly on patients, regardless of their different needs. Individuals and employers shopping for health coverage should not be expected to know that $1500 is an unreasonable cap on prosthetic coverage. In essence, these insurers are advertising that they cover prosthetics, but when patients need that coverage, it isn’t actually paid for.

One of P&O Care’s own patients, orthopedic surgeon Dr. Matthew Bradley (picture above), has testified before the Oregon State Legislature on behalf of a parity law that seems likely to pass there this year. Now, Matt has plans to use his expertise to help work for parity legislation here in Missouri. Through a new committee, P&O Care is joining with individual citizens, prosthetic providers, and advocacy groups all over the Show Me State to get a parity law passed here in 2008.

Besides Oregon, six other states have already passed prosthetic parity laws, including Colorado Maine, New Hamshire, Rhode Island, California, and Massachusetts, where former Governor Mitt Romney was a key supporter. Missouri Governor Matt Blunt has announced that he is supporting Romney’s bid for President: Does that mean he might support prosthetic parity, too?