MN SF2139

Requires health plans to provide coverage for orthotic and prosthetic devices, supplies, and services consistent with federal Medicare coverage standards under Social Security Act sections 1832, 1833, and 1834.

Defines prosthesis as external medical devices replacing missing limbs or body parts (including repairs and replacements) and orthosis as custom-fabricated devices for correcting deformities or providing support, both requiring prescriber medical necessity determinations.

Limits coverage to the most appropriate medically necessary model as determined by prescribing physicians or licensed health care prescribers, including design, fabrication, fitting, and maintenance to restore activities of daily living and job-related activities.

Prohibits preexisting condition limitations, restricts dollar maximums to annual or lifetime caps applied to all plan services, requires equal reimbursement rates as other contracted medical services, and permits prior authorization only to the same extent as other covered benefits.

Effective August 1, 2010, applies to all health plans issued or renewed for Minnesota residents on or after that date, and requires devices be provided by accredited providers and prescribed by licensed physicians or health care providers.