HB 5009 Summary

• Increases annual ostomy appliance and supply coverage from $1,000 to $5,000 for both individual and group health insurance policies, effective January 1, 2011.

• Requires prosthetic device coverage (including microprocessor-equipped artificial limbs) equivalent to Medicare standards for both individual and group policies, with coverage for medically necessary repairs or replacements and restrictions on out-of-pocket expenses.

• Extends hearing aid coverage for children from age 12 to age 18 or younger, limited to $1,000 within a 24-month period.

• Requires coverage for human leukocyte antigen (HLA) testing for bone marrow transplantation candidates with no more than 20% coinsurance, copayment, deductible or out-of-pocket expenses.

• Expands cancer treatment coverage including wigs prescribed for hair loss from chemotherapy or alopecia areata (in addition to oncologist-prescribed wigs), and mandates colorectal cancer screening without patient cost-sharing for additional colonoscopies ordered by physicians.

• Authorizes employers to offer wellness program incentives (rewards, premium reductions, or reduced copayments up to 20% of premiums) while establishing an exemption from rebate prohibitions for compliant health behavior programs.