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Hearing on prosthetics, orthotics coverage draws personal testimony and insurer concerns over medical‑necessity language
Summary
House Bill 87 drew a hearing of patients, clinicians and insurers after the sponsor asked lawmakers to expand the definition of medical necessity so insurers may cover additional prosthetic and orthotic devices for activities such as showering, exercising and adaptive sports.
Representative David Clark introduced House Bill 87 in a hearing-only session to change how medical necessity is defined for orthotics and prosthetics, seeking to allow coverage for additional devices tailored to activities of daily living and physical activity.
Clark said current law and common insurer criteria exclude devices described with specific activities — for example, running or showering — and that the bill would permit coverage when a licensed prosthetist‑orthotist (CPO) and treating physician determine a second device is medically appropriate to meet a patient’s goals and functional needs.
Multiple Georgians described how coverage gaps affect…
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