Apr 14, 2009
National MS Society Commends Assembly Health Committee on Passing Durable Medical Equipment Legislation
Bill to Ensure Private Health Insurance Companies Cover Durable Medical Equipment Moves to Floor of Assembly
Sacramento: April 14, 2009 —Today a bill (AB 214 - Chesbro) that will require health insurers to provide coverage of Durable Medical Equipment (DME) passed the California State Assembly Committee on Health. The National Multiple Sclerosis Society, Disability Rights Education and Defense Fund (DREDF), and Disability Rights California (DRC) commend the committee on protecting the rights of people living with disabilities and encourage the full Assembly to pass this important piece of legislation when it comes to vote later this month.
Whether one is born with or acquires a health condition later in life, there are many reasons why someone might need help with such basic functions as breathing, getting around, or using the restroom. To cope with these issues, patients use a variety of devices such as crutches, oxygen devices, wheelchairs, blood glucose monitors, hospital beds, walkers, and other reusable medical equipment.
While public insurance programs such as Medi-Cal and Medicare fully cover DME, up to 90% of California’s private group health insurance plans now have an annual $2000 benefit limit on DME that cannot be carried forward from one year to the next. Individual health insurance plans often have an annual DME benefit cap imposed in addition to hefty monthly premiums and high deductibles. Over half of California’s three million people with disabilities have private heath insurance and an estimated 326,000 work age (18 – 64) Californians need some form of DME.
AB 214 requires health insurers to provide coverage of DME in group and individual plans, and prevents plans from placing special coverage limitations on DME. The bill will not change the general requirement that DME must be medically necessary and prescribed by a licensed healthcare provider before it is covered by private insurance.
The bill is authored by Assemblymember Wes Chesbro (D-Arcada) and co-sponsored by the National Multiple Sclerosis Society - California Action Network, Disability Rights Education and Defense Fund (DREDF), and Disability Rights California (DRC).
“Without this bill, people with disabilities and their families will continue to go into debt and be forced to forego saving for their future retirement or their children’s education in order to purchase this equipment,” says Assemblymember Chesbro. “This much-needed bill will dramatically decrease out-of-pocket spending for people with disabilities and reduce the financial hardship associated with their health condition and will hardly make a dent in overall private insurance costs.”
“The durable equipment cost limit has been a big problem for me,” says Jonathan Austin of Oakland who has been living with MS since 1998. “My physical therapist has recommended that I use an electronic knee brace that will enable me to walk farther and more efficiently, however the price of this device is over $6000 and my insurance carrier responded that they have a $2000 limit on devices. We’re hoping to try a less expensive device, however the efficacy of this less expensive device for treating my symptoms is unknown. I think it’s vital that the California State Legislature pass this important bill, as it would make a huge difference in the daily lives of those of us living with disabilities and chronic illnesses.”
Now that the bill has passed from committee, constituents and encouraged to contact their representatives in the state assembly and encourage them to vote for passage of the bill. To learn more about the bill, visit www.msconnection.org/advocacy.
About the National Multiple Sclerosis Society – California Action Network
The National MS Society – California Action Network (MS-CAN) is an advocacy coalition formed by the three Society chapters serving the Golden State. It coordinates a unified, statewide response to political issues of concern to people with MS. Members of the MS-CAN engage in letter-writing and telephone campaigns, as well as face-to-face meetings with state, local and federal officials. Their grassroots efforts are essential to guarding the rights of people with MS and the commitment of members nationwide makes the National MS Society one of America’s most respected voices on healthcare issues. www.msconnection.org/advocacy
About Disability Rights Education and Defense Fund
Founded in 1979 by people with disabilities and parents of children with disabilities, the Disability Rights Education and Defense Fund (DREDF) is a national law and policy center dedicated to protecting and advancing the civil rights of people with disabilities through legislation, litigation, advocacy, technical assistance, and education and training of attorneys, advocates, persons with disabilities, and parents of children with disabilities. For more information, visit www.dredf.org
About Disability Rights California
Disability Rights California is a non-profit advocacy agency that provides free legal services to advance the human and legal rights of persons who have disabilities. Under HAVA, Disability Rights California is charged with ensuring “the full participation in the electoral process for individuals with disabilities, including registering to vote, casting a vote and accessing polling places.” Since receiving HAVA funds, Disability Rights California has engaged in a range of voting-related activities, including registering Californians with disabilities to vote, developing nonpartisan educational materials, providing education and outreach, working with the Secretary of State and county election officials and helping voters with their individual voting issues. www.pai-ca.org