This bill amends existing laws to expand health benefits coverage for orthotic and prosthetic appliances by requiring coverage for an additional appliance when deemed necessary by a physician for participation in physical and recreational activities. Previously, the law only mandated coverage for appliances considered medically necessary, without provisions for additional appliances for non-medical purposes. The bill applies to various health service entities, including health service corporations, medical service corporations, individual and group health insurance policies, small employer health benefits plans, and health maintenance organizations.

Additionally, the bill ensures that reimbursement for these additional appliances aligns with the federal Medicare reimbursement schedule, thereby standardizing the benefits provided for these items to the same extent as for other medical conditions. The provisions of this act will take effect 90 days after enactment and will apply to policies or contracts issued or renewed on or after that date.

Statutes affected:
Introduced: 17:48-6, 17:48A-7, 17:48E-35.30, 17B:26-2.1, 17B:27-46.1, 17B:27A-7.13, 17B:27A-19.17, 26:2J-4.31, 52:14-17.29