A BILL FOR AN ACT to amend the Indiana Code concerning insurance.

Plain English Breakdown

Checked against official source text during the last sync.

Insurance Requirements for Orthotic and Prosthetic Devices

This bill sets rules for health plans, insurance policies, and HMOs to cover orthotic and prosthetic devices and requires reports about these claims.

What This Bill Does

• Requires state employee health plans, accident and sickness insurance policies, and health maintenance organization contracts to cover orthotic and prosthetic devices.
• Asks the state personnel department, insurers, and HMOs to report on the number of claims and money paid for orthotic and prosthetic devices by October 1, 2027.
• Requires the insurance commissioner to collect all these reports and send a summary to the relevant committees in both houses of the Indiana General Assembly by December 1, 2027.

Who It Names or Affects

• State employees with health plans
• People who have accident and sickness insurance policies
• Members of health maintenance organizations (HMOs)

Terms To Know

Orthotic devices

Devices that support or correct the function of a part of the body, like braces.

Prosthetic devices

Artificial limbs or other body parts used to replace those lost due to injury or illness.

Limits and Unknowns

• The bill does not specify what happens if the requirements are not followed.
• It is unclear how this will affect insurance costs for individuals and employers.

Official Summary Text

A BILL FOR AN ACT to amend the Indiana Code concerning insurance.
Coverage of orthotic and prosthetic devices.

Current Bill Text

A BILL FOR AN ACT to amend the Indiana Code concerning insurance.

Coverage of orthotic and prosthetic devices.

Sets forth requirements for coverage of orthotic devices and prosthetic devices by a state employee health plan, a policy of accident and sickness insurance, and a health maintenance organization contract. Requires, not later than October 1, 2027, the state personnel department, an insurer that issues a policy of accident and sickness insurance, and a health maintenance organization to submit a report to the insurance commissioner regarding the total number of claims and the total amount of claims paid for orthotic devices and prosthetic devices during the preceding plan year. Requires the insurance commissioner to: (1) aggregate the data received in the reports regarding coverage of orthotic devices and prosthetic devices; and (2) report the aggregated data, not later than December 1, 2027, to the standing committees of the house of representatives and the senate that consider insurance matters. Makes corresponding changes.