Patients and clinicians back bills to require insurance coverage for activity‑specific prostheses

A broad coalition of patients, clinicians and suppliers told the Joint Committee on Financial Services that activity‑specific secondary prostheses — running blades, swimming legs, water legs, and sport‑specific arms — are routinely excluded by insurers even though they are clinically indicated to maintain physical activity, prevent secondary injuries and improve mental health.

Multiple witnesses provided personal accounts: Mike Benning (amputee and former Paralympic athlete) described different prostheses he used for weightlifting, daily tasks and high‑impact sport; Kevin Chambers said that his running blade cost him over $12,000 and had to be raised via crowdfunding. Prosthetic‑service providers and Spaulding Rehabilitation clinicians (including the medical director of the amputee program) testified about organized adaptive programs, training groups and the long‑term health benefits of enabling exercise for people with limb loss.

Policy witnesses cited low estimated premium impacts (commonly quoted in testimony as between 1¢ and 28¢ per member per month) and potential downstream savings by preventing knee/hip damage and other costly complications. Clinicians recommended qualification and review processes for activity devices similar to those used for primary prostheses.

The committee did not vote on the bills at the hearing; sponsors urged the committee to move language that would extend coverage to MassHealth and fully insured policies, and to adopt clinical review and authorization procedures.