Tennessee committee approves bill for insurance coverage of activity-specific prosthetics

In a recent meeting of the House Insurance Subcommittee, significant strides were made toward improving healthcare access for Tennesseans, particularly those with limb loss and differences. The committee approved two key bills aimed at enhancing insurance coverage for essential medical devices.

The first bill focuses on holding pharmacy benefit managers accountable to prompt payment standards, similar to those required of health insurers. This legislation aims to eliminate limits on penalties for violations, allowing the Tennessee Department of Commerce and Insurance (TDCI) to impose stricter penalties on repeat offenders. This move is expected to ensure that patients receive timely access to necessary medications, ultimately benefiting the community by improving health outcomes.

The second bill addresses a critical gap in insurance coverage for individuals living with limb loss. Currently, many insurance plans do not cover activity-specific prosthetics and orthotic devices, which are essential for physical activity and exercise. The legislation seeks to mandate that insurance companies provide coverage for these devices, which are often deemed "not medically necessary." This change is particularly important for children and active individuals who require specialized equipment to engage in sports and other activities. By ensuring access to appropriate prosthetics, the bill aims to enhance the quality of life for many Tennesseans.

Both bills passed unanimously in the subcommittee and will advance to the full insurance committee for further consideration. These legislative efforts reflect a commitment to improving healthcare access and addressing the unique needs of residents, particularly those facing physical challenges. As these bills progress, they hold the potential to make a meaningful impact on the lives of many in the community.