Bill > LB410

This bill requires health insurance policies and self-funded employee benefit plans in Nebraska to provide coverage for prosthetics and orthotics that is at least equivalent to Medicare's coverage, effective January 1, 2024. The coverage must include medically necessary prosthetics and orthotics as determined by the patient's treating physician, including repair or replacement when appropriate. While insurers can require patients to use in-network prosthetists, they must also allow access to out-of-network providers for prosthetic services to the same extent as other covered benefits. The bill defines orthotics as custom medical devices used to correct deformities or improve body function, and prosthetics as artificial limbs and associated components. Insurance policies cannot impose specific annual or lifetime dollar limits on prosthetic and orthotic coverage beyond general policy limits, and standard deductibles and copayments may still apply. The requirement applies to most individual and group health insurance policies, with exceptions for short-term and limited-benefit plans, and is subject to federal law preemption for self-funded employee benefit plans.

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https://nebraskalegislature.gov/bills/view_bill.php?DocumentID=59036