SB1390 Summary

• Requires health benefit plans offered, issued, or renewed on or after January 1, 2011 to provide coverage for prosthetic devices (artificial limbs) at least equivalent to federal Medicare program coverage.

• Coverage is limited to the most medically appropriate model that adequately meets the patient's needs as determined by the treating physician.

• Allows health benefit plans to require prior authorization for prosthetic devices using the same procedures as other covered benefits, and requires coverage for medically necessary repairs or replacements.

• Defines "health benefit plan" to include group insurance, HMOs, PPOs, and the State Education Employees Group Health Insurance plan, but excludes certain ERISA-exempt plans.

• Becomes effective November 1, 2010.