Governor Jay Nixon has Signed MO Prosthetic Parity Legislation HB 577

The bill was signed Monday, July 13, 2009.

Prosthetic Parity Passes MO General Assembly!

Prosthetic parity legislation passed the MO Senate Friday with ten minutes to go till 6:00pm. It passed the house earlier in the day as an amendment to HB 577, an insurance bill. Now all it needs is an almost certain signature by Governor Jay Nixon.

The parity law enjoyed a dramatic last few days. It had been attached to the enormous health care bill SB 306, which passed the House but died in the Senate. Then on Thursday, it was stripped from HB 577 before Rep. Maria Chapelle-Nadal argued for it to be put back in. Without her persistence, this legislation never would have made it. Finally, Missouri Coalition for People with Limb Loss lobbyist Kent Gaines was able to dissuade some opposition in the final moments so the bill could pass.

Prosthetic Parity Bill Update

The Prosthetic Parity Bill made it through the House last night as an amendment on SB 306. Now it must go back to the Senate for final approval. Please call or email your senator and ask him or her to support SB 306.

Passed!

The MO Prosthetic Parity Bill has been attached to another bill (SB 306) as an amendment and passed by the full Senate. On to the House now, where it has the support of insurance companies due to our compromise. The bill now calls for a mandated offer instead of mandated coverage, which means that insurance companies have to offer everyone plans that contain full prosthetic coverage without caps, but you could theoretically save $4 per year by opting out.

The Missouri Prosthetic Parity Bill (HB 616) passed out of the House Health Care Policy Committee unanimously (10-0) yesterday 4/1/09.

Missouri Prosthetic Parity Bill Passes Senate Committee

This past Tuesday, 3/10/09, the Missouri Senate committee considering the Prosthetic Parity Bill voted unanimously (7-0) to pass it. Now it must be passed by the House committee and then by the full house and senate. Things are looking good for parity in Missouri!

House Hearing on Prosthetic Parity Moved to Wednesday, March 4

This is a follow-up to the earlier post regarding the hearings on the prosthetic parity bill. Our lobbyist, Kent Gaines informed me that the House Committee hearing has been moved to next Wednesday, March 4, at noon. The Senate hearing is Tuesday, March 3, at 8:15 am.

For more information on the Senate bill, please see:
http://www.senate.mo.gov/09info/BTS_Web/Bill.aspx?SessionType=R&BillID=708463

For more information on the House bill, please see:
http://www.house.mo.gov/content.aspx?info=/bills091/bills/hb616.htm

We do not have information yet on where the hearings will be held since the online hearing schedule does not yet reflect all of the hearings for next Tuesday and Wednesday.

We are looking for a strong presence at both of the hearings. Please contact Jean Freeman at 314-606-0442 or Jeff Damerall (314) 853-1910 if you are interested in attending.

Hearings for Prosthetic Parity in Jeff City March 3

Mark your calendars foe Tuesday, March 3. Our Lobbyist Kent has arranged hearings for us in front of senate and house committees. Hearing times are 8:30am and 12:00pm. If as many amputees as possible could come, that would be great. We need to pack the rooms, and some of us will be able to speak/testify to the lawmakers.

Our Prosthetic Parity Bill Assigned to Great Committees

The Missouri Prosthetic Parity Bill is HB 616 in the House and SB 320 in the Senate. It has been assigned to the House committee on Health Policy, chaired by our bill sponsor Rep. Dr. Wayne Cooper, a Republican from Camdenton. In the Senate, it has been assigned to the committee on Health, Mental Health, Seniors and Families, chaired by Senator Norma Champion – R (Springfield). Last year we were assigned to the insurance committees, so this is a positive development. You can follow the progress of these bills by clicking on the links provided. If you live in Senator Champion's district around Springfield, MO, please call her and let her know of your support for SB 320. We expect to have hearings around the beginning of March--coming up quick--so please make plans to attend, especially if you are an amputee affected by insurance caps on your coverage.

STLtoday - Pinning blame on patients for costs won't lead to

Doug Ervine, Republican State Rep for the Health Insurance industry here in the great state of MO, thinks that people would take better care of themselves if they had to pay out of pocket more. Mary Jo Feldstein thinks otherwise.

read more | digg story

Missouri Prosthetic Companies Should Financialy Support Parity

Recently, the MCPLL has had a harder time than expected getting financial support for prosthetic parity from the prosthetic industry here in Missouri, who should be the first to support this legislation. Working-age amputees are leading the effort, and they stand to gain the most in terms of quality of life. But prosthetic companies are the ones with the money who understand the issue and deal with the insurance companies most directly, and they also stand to benefit financially from the passage of parity legislation. That means they should pay the bulk of what it costs to get any law passed in our society (for good or ill), and that means paying a professional representative, also known as a lobbyist. However, it’s becoming more and more difficult to stay current on our payments to our lobbyist, Kent Gaines, who is doing an excellent job gaining strategic allies in the legislature.

At first, several companies jumped at the chance to give, so we had money in the bank, and some of them have even stepped up to shell out more money as it starts to run out. But fewer and fewer practices seem interested. Amputees in Missouri are urged to take a look at the list below, also found in the right margin, where it will be constantly updated as new checks and pledges come in.

Illinois does things differently. They have a professional association of prosthetists and orthotists that collects dues, and some of that money goes to its government relations efforts, including parity. Here in Missouri, efforts to get just such an association started led first to our highest priority, helping our patients get this law passed.

Here is the list of contributing prosthetic practices in MO, in alphabetical order, also available on http://molimbloss.blogspot.com:

• Advanced O & P (pledged)
• Central Brace Company
• Hanger O & P
• Lux O & P (pledged)
• O & P Design
• O & P Labs
• P & O Care

The following individual prosthetists have also made personal contributions:

• Dan Luitjohan
• Richard Haws
• Richard Thiele

Parity Fact Sheet: Good Medicine for Working Families

General Campaign Fact Sheet - Upload a Document to Scribd

Quest for Parity in Kansas

Check out this blog on the quest for prosthetic parity coverage in Kansas. It sounds like Elizabeth Dole (R-NC) might introduce our bill in the U.S. Senate.

Update: Prosthetic Parity across the Nation

The cover story by Jennifer Hoydicz about prosthetic parity for the new issue of O & P Business News contains an update on the MCPLL’s efforts here in Missouri. You can read the full story here or the excerpt below:

The 2008 legislative session gave the Missouri bill a chance to begin movement. The bill was referred to the Senate committee and passed but session adjourned before the bill could be heard on the floor. Organizers, Jeff Damerall, Jean Freeman and Bill McLellan are all pleased with the movement and reception the bill has received thus far.

“We are looking forward to the next session in 2009 and having a prosthetic parity bill put forward in the House and the Senate,” Freeman said. “We were happy with the turnout for the Senate and the House hearings but particularly the House hearings. We had 20 to 30 individuals there … and it made an impression on the representatives.”

McLellan explained that the Missouri prosthetic parity bill was coupled with an autism parity bill and in the process was amended to become a mandated offer bill instead of a pure mandate.

“An offer … requires health insurance companies to offer to sell individuals and companies policies that include prosthetic coverage but not all of their policies have to include prosthetic coverage,” McLellan said. “So companies and individuals can choose to buy less expensive policies that don’t include prosthetic coverage. This was a compromise we were willing to make with the insurance companies in our first year.”

Despite the compromise, the bill stalled. The bill will be reintroduced in January 2009 to a better educated and informed group of legislators.

“We have made a lot of headway with individual legislators and bringing in that momentum which is helpful,” Damerall said.

When the bill is reintroduced, that momentum will be particularly important as they are expecting to enlist new sponsors for the bill as well as additional legislators for support.

“We are trying for everything we want,” Damerall said, explaining that they are aiming to change the language once again for full coverage. This time we are saying that if you provide individual coverage or group coverage, small group coverage, whatever coverage you are going to provide the benefit not just the offer.”

To continue the momentum and keep motivations high, the Missouri campaign is planning a number of events this summer which they hope will continue to raise awareness.

Sound Bite

"Health insurance companies are going behind their customers' backs and capping their prosthetic coverage well below actual costs, or they are limiting amputees to one prosthesis per lifetime. We want to pass a law in Missouri that says they can't do that."

Lacy Clay Supports Federal Prosthetic Parity Bill

U.S. Representative from St. Louis Wm. Lacy Clay supports the Federal Prosthetic Parity Bill and will even sign on as a co-sponsor, he told MCPLL Chair Jeff Damerall during the ACA's National Lobby Day in Washington D.C. last week.

Besides the oppressive 100 degree heat, Jeff and his wife had a fun time seeing the sights and meeting with law makers, including Missouri Senator Claire McCaskill and staffers for Senator Kit Bond.

Mandated Offer or Mandated Coverage?

I just got off the phone with Dan and Morgan with the ACA, and they were incredibly helpful. First, on the mandated offer issue: they said that the issue really comes down to whether insurance companies right now are cutting coverage completely or just restricting coverage with caps. Since in Missouri they are using caps and other clauses, a mandated offer would do the trick for us. The Federal bill is actually a mandated offer, a compromise they made since it would take forever to get anything at all in some states.

Morgan recommended that we not compromise on individual policies; some are regulated on the Federal level because they are self-insured, but we should insist that any mandated offer legislation cover both group plans and all individual plans regulated at the state level. And, we should make sure that when prosthetic coverage is offered, that coverage is at the level of Medicare without caps or other restrictions. Our negotiating strategy going forward could be that we come back with this kind of proposal, rather than completely playing hardball and demanding mandated coverage. The downside is that, as Jean and Suzi pointed out last night, amputees who need to get individual coverage may still face a pre-existing condition exclusion.

I need to get them the names of key legislators we hope to move to our side of the issue. Morgan said that they can help us get some targeted press in that legislator’s district and maybe organize a meeting of our supporters in their district. This is sometimes especially difficult for rural districts, and they said they could help; so if you guys remember who might have been on-the-fence with the power to make the bill move, send me the name. Maybe Kent can help with this, too.

Any more ideas, let me know. Hope all this is helpful. And please let’s dialogue about the mandated offer/coverage issue; we may want to start out asking for coverage and then compromise later on an offer only if we have to.

Prosthetic Parity Bill Passes out of MO Senate Insurance Committee

Last week, the Senate Insurance Committee voted to pass a prosthetic parity bill that would force health insurance providers to offer uncapped prosthetic coverage to employers and individuals. Now it needs to pass in the full Senate, the House Special Committee on Health Insurance, and the full House before going to Governor Bond for a signature.

Prosthetic Parity Hearings a Huge Success!

Members of the Limb Loss Coalition and amputees from across the great state of Missouri showed up in Jefferson City Tuesday to support the Prosthetic Parity Bill before House and Senate Committees.

Around 2:00 p.m., four witnesses testified before the Senate Small Business and Insurance Committee, chaired by Senator Lowden. Dr. John Rush, Medical Director for Hanger Orthopedic and a national expert on prosthetic parity, flew in to testify on many of the more technical issues. Then Mark Wilson, President of Prosthetic and Orthotic Design, Inc., in St. Louis testified that as a small business owner, he was not given the option of purchasing health insurance that did not include ridiculously low caps on prosthetic coverage. Next, Jeff Damerral, Chairman of the Missouri Coalition for People with Limb Loss, testified about his personal experience loosing both his legs below the knee to meningitis while a freshman at Truman State University. Damerral said that while he had good insurance through his father at the time, he is fighting for everyone who doesn't. Now that he is on his own and working as a lawyer for a small firm, Damerral must pay approximately $16,000 every 3-5 years to have his two legs replaced. Finally, AK amputee and Secretary of the Coalition Jean Freeman brought the whole room to the verge of tears, telling how caps on her prosthetic coverage force her to hope that the various parts of her prosthesis don't wear out at once. "As an amputee, I am being discriminated against," she said.

Several registered lobbyists for the insurance companies spoke briefly against the bill, saying they opposed prosthetic parity for the same reason they have always opposed every other "mandate" the state has passed, such as those insuring coverage for mental health, women's health screenings, and wigs for children with cancer. They believe on principle that policies should be able to exclude coverage for any condition, provided that policy can be sold to a customer or employer. On being questioned by Senator Day, one gentleman did not know that some plans include once-in-a-lifetime clauses for prosthetic devices. "Do you mean that a person is expected to wear the same leg at 18 months as 18 years?" she asked incredulously. "I'll have to get back to you with that information," he replied.

The hearing in the house began around 7:00 p.m., and since it was after business hours, many more supporters showed up. The bill sponsor, Rep. Dr. Wayne Cooper, introduced it to the committee, and Dr. Rush, Jeff, and Jean testified again. This time Jon Wilson, Clinical Director of Prosthetic and Orthotic Care, Inc., represented the state's prosthetists. "Surgeons often ask me to speak with patients before they loose their limbs, often to convince them that it's worth an amputation to save their life. I tell them I can help them walk again," Wilson said. "But later, when they're ready for the prosthesis, I have to be the one to tell them that their insurance won't pay for it. When they need health insurance the most, it isn't there."

Wrapping things up was Bill Brannan. He told how good health insurance has enabled him to live a productive life for ten years since he lost his leg at age 65; but he also told about meeting a young mother in a grocery store, juggling her kids and her cart and trying to get along in a wheelchair because her husband's insurance would not pay for her to get a prosthesis. The fine individuals who had to get up and represent the insurance companies after Bill sat down seemed like they were just going through the motions, stating rather plainly that they always oppose mandates, even inexpensive ones that seem to make all the sense in the world like ours does.

The representatives seemed to understand our case, and members from both parties told us the hearing had gone extremely well. It's always dangerous to get over confident, but here is what Dr. Rush thought comparing the parity effort in Missouri with other states where he has testified: he said that whereas elsewhere most of the real work gets done behind the scenes and hearings are just window dressing, we could have actually won our case in one day on hearings alone! We'll wait and see just where things go from here.