Other news: Amputees seek better insurance coverage for prosthetics


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CHATTANOOGA — Amputees and prosthetics makers are pushing Tennessee to require health insurance to cover the cost of replacement limbs. Some private insurance pays only $1,000 to $2,000 for a prosthetic which may cost 10 times that much while other insurance limits the patient to one device per lifetime. A state legislative committee is expected to consider requiring insurers to cover what Medicare does, about 80 percent of the prosthetic cost and a replacement every three to five years. But Rep. Richard Montgomery, a Sevierville Republican, says passage is unlikely because the bill would increase TennCare costs. TennCare reimburses prosthetic providers about 33 percent less than Medicare. But spokeswoman Marilyn Wilson says that if a doctor orders the prosthetic, "it is covered." Montgomery said the state's tight budget will be a factor in considering the bill. "No question it's an important piece of legislation that's got to be addressed, but you've got to make choices, and I don't think that's one that will be made this year," he told the Chattanooga Times Free Press. The bill failed last year because the fiscal impact on TennCare was calculated at $1.5 million. Private insurers oppose the mandates, which have been enacted in nine states and are being considering in 31 states. Chattanooga-based BlueCross BlueShield of Tennessee officials said the mandates have been shown to raise premiums for private insurance. Spokeswoman Mary Thompson said the company doesn't have a cap on what it will pay for prosthetic. But when an insurer does have a cap, it is often the prosthetic manufacturer that absorbs the cost. The Amputee Clinic in Chattanooga provided 30 patients with free prosthetic care last year because the insurance coverage was limited. "It's killing us," said owner Marcum Randall. "We're just not getting paid."
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