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Senate committee backs bill to expand coverage for prosthetics and activity limbs
Summary
The Senate Banking and Insurance Committee on Feb. 12 passed CS for SB 1110 after testimony from patients and advocates urging insurers and Medicaid to cover medically necessary orthotics and prosthetics — including activity limbs for children — and after an amendment clarified eligible beneficiaries.
The Florida Senate Banking and Insurance Committee reported CS for SB 1110 favorably on Feb. 12, moving a measure that would require Medicaid, individual and group health plans, and HMOs to cover medically necessary orthotics and prosthetics, including activity limbs for sports and recreation, without lifetime or continuous-use caps.
Senator Truenow, sponsor of the bill, said the measure authorizes Medicaid to cover specified orthotics and prosthetics, directs the Agency for Health Care Administration to seek federal approval when needed, and requires annual reporting on coverage and payments. An amendment (Barcode 277724) adopted in committee clarified eligible beneficiaries to include children under 18, college-age children up to 26 living at home, and disabled adults.
Families and patients delivering emotional testimony described high costs and gaps in coverage. Kim Rawls of the Amputee Coalition recounted her son Ben’s experience: “After cancer treatment, Ben was amputated of his right leg … Running leg cost about $5,000. Ben broke 10 of them,” and families often face repeated replacement costs when insurers treat activity limbs as nonessential. Tobias King, a high-school senior and prosthetic user, said the bill “treats activity limbs as medical needs, not add ons,” and told senators the devices allowed him to participate in sports and improved his mental health and school performance.
Parents and clinicians gave specific cost estimates to illustrate financial strain. One witness said typical everyday prosthetics for a child cost about $10,000 per year and that specialized gymnastics prosthetics they had obtained through private sponsorship were estimated at about $45,000. Another witness said families may have borne roughly $100,000 over a child’s lifetime even with partial insurance coverage.
Supporters argued the fiscal impact to Medicaid would be modest. Olivia Keller summarized analyses indicating the Medicaid fiscal impact would be “hundreds of thousands of dollars,” and that premium increases per member would likely be “anywhere from a penny to a dollar” per month. Advocates said increased access could reduce long-term health costs tied to inactivity.
Several senators praised the testimony and expressed support. Senator Hooper called the bill possibly the most important of the sponsor’s career, and senators acknowledged the committee was attentive to testimony from young people and families.
The committee adopted the amendment, heard additional testimony and waived further debate. Amora conducted a roll call and reported CS for SB 1110 favorably to the Senate.
