IN THE NEWS! Push for health coverage for prosthetic care

A letter to the editor — 11/20/2007

Dear Editor: Currently, due to archaic insurance regulations, prosthetic care is being put out of reach for many amputees in Wisconsin. Insurance plans are restricting or even eliminating coverage for prostheses. This is a matter that Congress must address.

In return for premiums paid for private health insurance, consumers expect to be covered for catastrophic illness or injury. They expect that their monthly premiums will provide them with the most basic of care, including prostheses.

Policy reports regarding prosthetic parity laws from Colorado, Massachusetts, California, New Jersey and Virginia suggest that the costs are minimal -- anywhere from 12 to 25 cents per member per month.

If amputees are prevented from accessing prosthetic care, this increases state Medicaid costs due to complications. The subsequent cost to the health care system far exceeds that of providing prosthetic care, while the lack of productivity places a huge burden on society.

Prosthetic parity bills have been launched all over the country, including in the state of Wisconsin. A federal prosthetic parity bill is going to be introduced next year. This bill would ensure that prostheses are treated the same as other basic, essential care.

Please urge your member of Congress to co-sponsor the federal parity bill when it is introduced. We must give people with limb loss the care they need to fully participate in society!

Morgan Sheets, national advocacy director, Amputee Coalition of America, Washington, D.C.

A letter to the editor — 11/20/2007 11:41 am

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Urge Rep. Tom Petri of Wisconsin to sponsor the federal parity bill!

Did you know that the Amputee Coalition of America is introducing federal legislation to protect access to prosthetic care?

The ACA has been working with states across the country to push for legislation that ensures that amputees get prosthetic care. Seven states have passed prosthetic parity laws, stating that prostheses must be covered on par with the federal Medicare program. This means that the restrictive caps and exemptions on repairs would no longer be allowed. There are currently 29 states advancing prosthetic coverage bills.

And now the ACA is taking the fight to Congress! But we need your help!

TAKE ACTION! We are pursuing Rep. Tom Petri (R-WI) to be an original cosponsor of the prosthetic parity bill. We need your help to demonstrate that people in Wisconsin support this important legislation.

It will take less than ten minutes. We just need you to send two e-mails. Easy, but it will make a difference! Contact information and a sample letter are included below.

• Contact Debbie Gebhardt. She is Petri’s Chief of Staff. She can be reached at debbie.gebhardt@mail.house.gov.
  
  
  
• Contact Lindsay Bowers. She is Petri’s Legislative Assistant for issues related to ERISA (a federal regulation for certain health plans). She can be reached at lindsay.bowers@mail.house.gov.

Think about sending us as copy of your e-mails, so we can track the number of messages that have been sent!

Sample E-mail:

Dear Ms. ______ (Gebhardt or Bowers):

I am writing to urge Rep. Petri to co-sponsor the federal prosthetic parity bill. This bill will ensure that prostheses are treated the same as other basic, essential care.

Numerous studies have been done that demonstrate that prosthetic parity is not only low cost to individuals under private and group insurance plans, but it also results in a savings to the private and public sector.

Prosthetic coverage bills have been launched all over the country. Currently, seven states have passed prosthetic parity laws. Another twenty-nine states, including Wisconsin are working to advance bills. It is time for Congress to take a stand on this important issue.

This is an opportunity to ensure that people with limb loss are given the care they need to fully participate in society! I hope that Rep. Petri will co-sponsor the federal parity bill when it is introduced.

Sincerely,

NAME, ADDRESS, PHONE

If you would like to be an overachiever and go one step further…

* You can also make a call to Petri’s office and leave a message urging him to sponsor the bill. Just call his office at 202/225-2476. You will be leaving a message with a staff person. They will ask for your name and hometown.


Sample Phone Message: I am calling to urge Representative Petri to sponsor the federal prosthetic parity bill. I am a member of the Amputee Coalition of America, the organization working to advance prosthetic parity. I think this is an important piece of legislation.

PLEASE TAKE ACTION TODAY TO HELP KEEP THE FEDERAL BILL MOVING!

If you have any questions about the federal campaign, please contact us at federal@amputee-coalition.org or 202/742-1886. To find out more about the Wisconsin campaign, visit Wisconsin's campaign page.

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You're Cordially Invited..

You are cordially invited to attend the Amputee Coalition of America 2nd Annual Holiday Party and Awards Ceremony!


Save the date: Wednesday, December 12 from 6:30 PM – 8:30 PM

Located at 1436 U Street, NW Suite 104. Washington, DC 20009.

Join us for free dinner, dessert and awards ceremony. Two community advocates will be recognized for their passion, time and commitment to people with limb loss.

For more information, click here.

R.S.V.P.: jperez@amputee-coalition.org

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Happy Thanksgiving from the Advocacy Team!

We would like to wish you and yours a very happy Thanksgiving!!

The ACA’s advocacy department has a lot to be thankful for this year! Read about our progress on the parity campaign. (left to right: Jeremiah Perez, national advocacy specialist; Morgan Sheets, national advocacy director and Sheila Van Pay, federal campaign organizer.)

TOTAL NUMBER OF STATES IN PLAY: 29

• 7 laws passed
• 19 states poised to introduce in 2008
• 5 states working to introduce in 2009
• 5 states building campaigns

And a federal bill will be introduced in 2008! Find out where your state stands in the national movement for prosthetic parity…

Region A Parity Update: ME, NH, VT, MA, CT, RI

Maine, New Hampshire, Massachusetts and Rhode Island all have a parity law on the books. To find out more about these state bills or to learn about the federal efforts in these states, check out our website, click here.

VT: We have spoken with a few activists in Vermont. It is still in the very beginning stages. VT is a target state for the congressional bill.

CT: We confirmed that Rep. John Geragosian will be sponsoring the bill. The committee is working on an educational event and lobby day in February when the session starts. This is a strong committee.

Region B Parity Update: NY, PA, NJ, DE

PA: The bill was passed out of the House committee and referred to the Pennsylvania Cost Containment Council. The council is currently reviewing the bill. They held a public comment period that ended on October 30th. They will come out with their report before the end of the year. This state has a very strong committee.

NJ: The bill passed out of the House Insurance committee. It passed the Senate Insurance committee with an amendment to add the state employee health benefits program. It is currently awaiting review by the Budget & Appropriations committee. They have scheduled a hearing for December 3rd. This state has a good state association with a lobbyist. That is who we coordinate with.

DE: Delaware’s campaign is just getting started. A local support group leader, Gloria Price is coordinating with a local prosthetist, John Horne to work with the ACA to launch a bill.

NY: This state has a strong committee. They pulled off a lot of press and organizing work last year, but this bill has not had a chance to be heard. It has died several sessions in a row due to a lack of support from the committee chairs. We are investigating an administrative strategy. Morgan is meeting with Eve and a contact with the Insurance Administration in November.

Additionally, we have an activist who has reached out to Majority Leader Canestrari and Senate President and Majority Leader Bruno to gain their support for the bill. They were part of an effort to help a young woman from Africa get prosthetic care in the U.S. We are looking to leverage these recent humanitarian efforts to get their support behind the parity bill.

We will continue to work towards a legislative remedy while looking into alternate strategies.

Region C Parity Update: DC, MD, OH, VA, WV

DC: DC regulations are actually overseen by Congress, so our federal effort will be of interest to DC area residents. Also, we have our monthly volunteer night.

To learn more about our volunteer program and December annual holiday party, click here.

MD: This is a fairly new committee. A lobbyist has been hired. The committee just confirmed a sponsor. Delegate Heather Mizeur has agreed to introduce the bill. Delegate Peter Hammen, Chair of the Heath and Government Operation Committee is drafting the bill and will be listed as a co-sponsor.

VA: The bill was referred to the Special Commission on Mandated Health Benefits. They are holding another hearing to vote on the bill on November 29th. This will determine whether or not the bill is allowed to move forward. This committee is small, but active.

WV does not have a campaign at this time. Anyone in WV interested in getting involved should contact us about the federal efforts (federal@amputee-coalition.org or 202/742-1886).

Region D Parity Update: IL, IN, MI, MN, WI

IN: The committee was invited to testify before the Health Commission in September. We have not been given their analysis yet. We are still pushing for introduction in 2008. This is a strong committee.

MI: This bill was introduced late in the session as a means to educate lawmakers. A full-scale effort will be launched with the re-introduction in January. This committee is small, but active.

WI: The committee has identified a legislator who will forward the bill to the "drafter" and see that the bill gets onto the docket for the 2008 session. There is a small, but active committee in place.

IL: The committee has a lobbyist. They are working to confirm a sponsor.

Minnesota does not have a campaign at this time. Anyone in MN interested in getting involved should contact us about the federal efforts (federal@amputee-coalition.org or 202/742-1886).

Region E Parity Update: FL, GA, NC, SC

GA: The Society has committed to working with us on this initiative. They are a smaller group. They have a lobbyist who is working to get the bill introduced. They do not have a sponsor confirmed. This effort kicked off at the 2007 ACA Conference.

FL: This bill will be introduced in 2008. The legislature requires a study. We have been coordinating with local partners to get this analysis completed. There is no real committee. The sponsor is working directly with us.

NC: This is a very strong committee. Unfortunately, they will not have an opportunity to introduce their bill until 2009. They have identified a few potential sponsors. We are working with them to keep up the momentum and use the federal initiative to build capacity. One of the lead activists just met with Sen. Burr.

South Carolina does not have a campaign at this time. Anyone in SC interested in getting involved should contact us about the federal efforts (federal@amputee-coalition.org or 202/742-1886).

Region F Parity Update: AL, KY, MS, TN

AL: The language has been drafted. The sponsor and committee are working with us to get it finalized. It will be introduced in January. They have a big policy forum coming up in December. The committee is small, but active.

KY: There is a very small committee. They have been focused on licensure, which they came very close to passing in 2007. They are looking to advance parity after licensure passes.

TN: This bill stalled in the 2007 session. We are working with local leaders to prepare for the re-introduction. We are working on expanding the geographic representation and improving the communication.

Mississippi does not have a campaign at this time. Anyone in MS interested in getting involved should contact us about the federal efforts (federal@amputee-coalition.org or 202/742-1886).

Region G Parity Update: IA, KS, MO, ND, NE, SD

IA: This bill passed the Senate last year. We had the votes in the House, but it was delayed by the Majority Leader. The bill will be re-introduced again in January. We are coordinating with the lobbyist to put pressure on the House leadership. Sen. Tom Harkin has also agreed to help us push for a vote. This state has a good state association with a lobbyist. That is who we coordinate with.

MO: The Missouri committee just met with Rep. Margaret Donnelly. She is willing to sponsor the bill. Sen. Harry Kennedy is also on board. They met with Senator Gibbons. He seems to be ready to co-sponsor. This is a strong committee.

NE: The committee is very small, but active. They meet regularly. They have a draft bill ready and the assistance of a lobbyist.

KS, ND and SD do not have a campaign at this time. Anyone in these states interested in getting involved should contact us about the federal efforts (federal@amputee-coalition.org or 202/742-1886).

Region I Parity Update: AR, LA, OK, TX

TX: This is a very strong committee. They came incredibly close to passing the bill in 2007. Unfortunately, Texas does not have a general session until 2009. We are working with them to keep up the momentum and use the federal imitative to build capacity.

LA: They just had their general elections. The runoff is this week. The session starts in March. We will work with them to confirm a sponsor now that they know who they are working with. There is a small, but active committee in place.

OK: Oklahoma has a strong activist who has been working to get a bill introduced. They hit some difficult roadblocks. We are hoping the fact that OK is a key federal state; this will help generate more activity.

Arkansas does not have a state campaign. Anyone in AR or OK interested in getting involved should contact us about the federal efforts (federal@amputee-coalition.org or 202/742-1886).

Region J Parity Update: AZ, CO, NM, UT, WY

UT: The lead activist presented before the Health and Human Services Committee in September. As a result, Representative Letivack has agreed to get a bill introduce a bill in 2008. There is not a real committee, just a few active volunteers. Contact the ACA to get involved (state@amputee-coalition.org or 202/ 742-1885).

AZ: They held their first organizing meeting in October. We are working to support the formation of a committee. This effort kicked off at the 2007 ACA Conference.

NM and WY do not have a campaign at this time. Anyone in NM or WY interested in getting involved should contact us about the federal efforts (federal@amputee-coalition.org or 202/742-1886). These are both targeted states for the congressional bill.

Region K Parity Update: CA, HI, NV

California passed a mandated offer bill related to orthotic and prosthetic care in 2006.

Hawaii and Nevada do not have a campaign at this time. Anyone in HI or NV interested in getting involved should contact us about the federal efforts (federal@amputee-coalition.org or 202/742-1886). These are both targeted states for the congressional bill.

Region L Parity Update: AK, ID, MT, OR, WA

WA: We just confirmed a sponsor for the bill. Their process is a bit complex and may prevent a vote from in 2008, but the bill will be introduced. We are working with the committee and the sponsor to finalize the language and compile an informal study. This is a strong committee.

AK: Mike Szymanski is a support group leader in Anchorage. He is a lobbyist. He is working to start a state campaign. He is also committed to helping with the federal initiative, since AK is a key state. Given his connections, he is confident he can pull off a state campaign in time for 2008. This effort is brand new, so a committee has not been formed yet.

Idaho and Montana do not have a campaign at this time. Anyone in ID or MT interested in getting involved should contact us about the federal efforts (federal@amputee-coalition.org or 202/742-1886).

Please, consider a holiday gift towards the parity efforts. You can donate directly to the parity campaign, click here!

For more information about our state campaigns, contact the ACA at 202/742-1885 or state@amputee-coalition.org. To learn more about the federal initiative, we can be reached at federal@amputee-coalition.org or 202/742-1886.

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Letter to the Editor: Prosthetic care won't break system

By Tami Stanley
Published: Monday, Nov. 19, 2007

Without legislation to ensure coverage, many people living with the loss or absence of a limb are facing discouraging obstacles when trying to obtain prosthetic care. Insurance companies are cutting or even eliminating coverage for prostheses. The Amputee Coalition of America is working to introduce federal legislation to address this issue. The bill would put the insurance coverage for prosthetic care on par with other basic, medical services.

Obviously, the biggest concern anybody has about passing a new mandate is cost. People fear that big jumps in the cost of insurance will reduce access to health care. None of us want to see health insurance costs pushed beyond the reach of the average consumer. Policy reports have been done in Massachusetts, California, Colorado, New Jersey and Virginia. They have found that providing prosthetics is low cost to individual consumers. Furthermore, it also saves money in the public and private sector.

A Department of Health Care Policy & Financing report found that the maximum increase in premiums for prosthetic provision would be about 12 cents per month. That is less than $1.50 per year. That is not going to push anyone off the insurance rolls or put anyone out of business. It will, however, get people the care they need to get back to work and live independent, productive lives.

Prosthetic parity legislation is supported by doctors, patients, prosthetists and a diverse range of organizations. In fact legislation is being considered at both the state and federal level. I am writing to urge Sen. Orrin Hatch and the rest of the Utah congressional delegation to support this important legislation.


Tami Stanley, a below-the-knee amputee, is a homemaker living in Orem.

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NEWS! A Race for Equality

The amputee community continues to face undue hardships and discrimination.

By Lauren Himiak

Millions of Americans with disabilities must face the daily obstacles many take for granted. And even though we are quickly approaching 2008, those learning to live with amputations still face hardship and discrimination. Oscar Pistorius, a double amputee from South Africa, recently attempted to qualify as the first amputee runner in the Olympics. Though he did not qualify, he created a world of controversy and is still making headlines.

In May 2007, The New York Times printed an article titled, “An Amputee Sprinter: Is He Disabled or Too-Abled?” (Longeman) and was not the only publication to share Pistorius’ story. Pistorius was born without the fibula in his lower legs and both were amputated above the knee when he was 11 years old. He has carbon fiber prosthetics and has been running for years, breaking many records along the way.

According to Times, Pistorius won the 200-meter race at the Paralympic World Cup this year, and his record performances include running 100 meters in 10.91 seconds, 200 meters in 21.58 seconds, and 400 meters in 46.34 seconds. (Longeman)

Yet, when he revealed his desire to race in the Olympics, many began questioning if Pistorius’ prosthetics gave him some sort of advantage over other runners.

“Until you have lost a limb, you cannot really understand the recovery,” noted Stephanie Guthrie, development and public awareness associate at the Amputee Coalition of America (ACA). “It is a slap in the face to say he has an advantage. Every study shows no prosthesis can accurately duplicate the human leg. I say if he is fast enough on his prostheses to keep up with the athletes who don’t have any, then he should be in there.”


The International Association of Athletics Federation (IAAF) — track and field’s world governing body — prohibits the use of technological aids like wheels and springs. It disqualified Pistorius from their events this year, and some argued a double-amputee would ruin the purity of the sport. (Longeman)

Because the International Olympic Committee creates its own eligibility rules, Pistorius was being considered for the Olympics, though he failed to qualify. No matter the outcome, he has brought much attention to the world of amputees and is a reminder that many are still not treated as equals.

Have You Checked Your Policy?

Another area where amputees are not treated equally is reimbursement for prosthetics. One of the biggest challenges amputees like Pistorius face is paying for prosthetics. Many insurance companies do not cover prosthetics in their entirety.

“At the ACA, we try to address the fact that most insurance companies have very low limits on what they will pay,” Guthrie stated. “And most people don’t consider looking into this sort of a thing on their insurance policy.”

Guthrie revealed many insurers will only pay up to $5,000 in a lifetime when a prosthetic can cost close to $100,000. In fact, amputee runners can expect to pay anywhere from $50,000 to $100,000 for a carbon-fiber prosthetic leg.

Of course, options that amputees can choose from vary, as prosthetics come together as a piece-by-piece assembly. Many factors come into the decision-making process including how high the amputation is, age and activity level. For example, if a young soccer player loses a leg, he is most likely going to be fitted with a different prosthetic than an elderly grandmother who is bed-bound. Also an amputee’s needs typically change over time. If you have a child who is missing an arm, you will need to purchase a prosthetic that fits the arm as the child grows. Some insurers only cover one prosthetic in a lifetime, creating a huge financial burden on many families.

“One of the big problems is that frequently a person’s needs will change over time,” noted Guthrie, “so the leg that was right for that person a year ago may not be right for him today.” And unfortunately, adjustments, new prosthetics and physical therapy don’t come cheap.

Adjusting for Life

For double-leg amputees, the physical therapy one endures varies from case to case. There will always be adaptations and new challenges to figure out along the way, but generally for PT there comes an end point.

“I have heard amputees say they think they can’t eat certain things, like salty foods because it will make their leg swell and then the prosthetic won’t fit properly,” said Guthrie. Truth be told, fitting is a lifetime challenge and will always require tweaking. Once a patient reaches a specific level of achievement in PT, generally they are done. Different PTs approach therapy differently and again, they all depend on the level of amputation.

According to Guthrie, it is a much quicker recovery if you have lost the leg below the knee. Above the hip is one of the most difficult to recover from because it is hard to get a natural gait.

“Many amputees say they want to be able to walk well enough so that if they are wearing pants, you cannot tell they have an artificial limb,” Guthrie noted. “But a natural gait is hard to achieve in a short amount of time.”

There can be a lot of discomfort associated with a prosthetic limb, especially if an amputee is not using it constantly. Taking it on and off can increase pain, as will changes in the body or in levels of activity.

Just Like You

Resources like the ACA are available for people with limb loss. Amputations occur for many reasons, including cancer, birth defects, trauma and diabetes. According the ACA, there has been a larger increase in the number of amputations due to diabetes. “There are about 1.9 amputees estimated in the United States,” Guthrie stated. “I believe the rate is growing the fastest it ever has in history.”

Amputees must face big challenges in the things many of us take for granted, such as being able to take a shower. The ACA provides information and support groups across the country. It also is involved in state rallies trying to change those laws that prohibit amputees.

Though it caused outrage in the amputee community that others would question an amputee runner’s equality in sports, Pistorius did effectively shine a light on a hard truth. Amputees are still not allowed the same rights such as proper health insurance, and still face adversity every day.

“Every study shows that there is no prosthesis that can accurately duplicate the human leg,” added Guthrie. “There will always be more energy required in using a prosthetic limb than in your own natural leg. It is constantly going to be something that hampers, not aids, when compared with a human leg.”

Lauren Himiak is a former assistant editor at ADVANCE.

For more information about the Amputee Coalition of America, click here.

Reference
Longeman, J. (2007, May 15). An amputee sprinter: Is he disabled or too-abled? The New York Times. Retrieved Sept. 17, 2007 from the World Wide Web.

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NEWS! ACA Expands Advocacy Department

Words: Morgan Sheets, national advocacy director
Photo: Sheila Van Pay, federal campaign field organizer

The Amputee Coalition of America (ACA) has experienced a great deal of success in advancing prosthetic parity at the state level. In order to take this fight to the U.S. Congress, the ACA hired a new staff member to help coordinate the outreach and organizing efforts it will take to launch a federal initiative.

The ACA is proud to announce the hire of Sheila Van Pay in the position of federal campaign field organizer. Van Pay comes to the ACA with a background in campaign management, community development, and public policy. She was previously employed as a member of the Scottish Parliament, where she helped elect 17 parliament and council candidates in the Gordon constituency during the 2007 Scottish Parliamentary elections.

As the ACA's federal field organizer, Van Pay will support all aspects of the federal campaign, including designing and implementing outreach strategies, distributing federal alerts to educate members, and organizing events to generate media attention and mobilize activists. This will include a National Day of Action in the spring, where activists from all over the country will put on an event to help push the federal campaign. This nationwide day of activism will help to demonstrate the support base for federal prosthetic parity.

Van Pay will also help to build the federal campaign through strategic initiatives, including letter-to-the editor campaigns, petition drives, in-district meetings, and lobby days, as well as using the local volunteers to meet the needs of the federal program.

"The ACA has grown substantially in the past few years, and the launch of our federal campaign is proof that the efforts of our staff, sponsors, and volunteers have been both beneficial and successful," Van Pay said. "Public health research and awareness has always been my passion. I am very excited to be a part of this important campaign."

Morgan Sheets is the national advocacy director for ACA's Action Plan for People with Limb Loss (APPLL) initiative. She can be reached at APPLL@amputee-coalition.org. For more information, visit www.amputee-coalition.org/advocacy/index.html

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NEWS! Amputee group celebrates new headquarters

By: Brittany Bailey, Reporter
Date created: 11/9/2007 11:26:16 PM

On Friday afternoon, the Amputee Coalition of America celebrated the grand opening of the new national headquarters and new money. The national non-profit, based in Knoxville, moved into a new office suite on East Hill Avenue.

Coalition leaders say the extra space will help the group's growing efforts.

Also, the ACA is celebrating a four-year renewal of funds from the CDC.

Right now, the organization says nearly two million American are living with limb loss across the U.S.

It's a number that has grown as injured war veterans return home, but leaders say diabetes causes the most amputations.

"There are so many life skills that you once knew, and now that you're an amputee, they've changed significantly, so it helps to have somebody guide you through the process, as well as just somebody who really can understand what you're going through," said Stephanie Guthrie, the group's development and public awareness associate.

Right now, Guthrie says the group is focused on getting states to implement minimum coverage requirements for prosthetics so that treatment for lost limbs is more affordable.

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NEWS! Amputees Push for Better Private Care

Nov. 5, 2007 Associated Press

WASHINGTON, D.C. - The nation's largest provider of amputee care says private health insurers are failing to meet the needs of Americans who require artificial limbs and it wants Congress to force a change.

Hanger Orthopedic of Bethesda, Md., and other advocates are lobbying lawmakers to mandate that private amputee coverage equal federal health insurance programs, such as Medicare.

Parity is critical, prosthetic makers and advocates say, because some insurers are hiking premiums and capping benefits, forcing some amputees to borrow from banks, max out their credit cards or shed assets to qualify for Medicaid in order to buy the artificial limbs or get necessary repairs.

The insurance industry, meanwhile, says it is providing cost-effective coverage to those who medically need such prosthetic devices. However, insurers oppose any such mandates for amputee coverage, arguing that it would simply make insurance less affordable to employers and raise health costs for the general population in the long run.

There are about 2 million amputees in the United States, including 701 service members from the wars in Iraq and Afghanistan, according to amputee and disabled veterans groups. Every year, about 75,000 Americans require amputations stemming from diseases, trauma or birth defects.

While amputees under military or government health coverage get needed care without worrying about financial limits or other restrictions, Morgan Sheets, the Amputee Coalition of America's national advocacy director, said tens of thousands of amputees or more with private insurance aren't getting what they expected to have.

Sheets' group has long lobbied for state laws that force private insurers to provide prosthetic care as a basic service, but started its federal campaign about a year ago. Sheets said Hanger, which hired Foley & Lardner LLP, is helping to fund the direct lobbying efforts.

The company, whose roots date back to the Civil War, is the 800-pound gorilla in the industry that designs, builds and fits custom-made prosthetics and orthotics, which are braces of some kind. The company accounts for nearly 25 percent of the $2.5 billion service industry, which is dominated by smaller private shops.

Hanger also started a political action committee last year to support state and federal lawmakers on a variety of issues, including parity, and expects to dole out $80,000 to candidates before the 2008 elections, said John Rush, Hanger's chief medical officer.

Several Republican and Democratic lawmakers have expressed interest in supporting federal legislation, which might be introduced early next year, said Sheets. But she said its success is unclear at this time.

Some insurers will only pay for one prosthetic during a patient's lifetime, cap payments up to $2,500, exclude repairs or require a 50-percent copay, Sheets said.

Tom Kirk, Hanger's president and chief operating officer, said an artificial leg can range in cost from $3,000 to $8,000, depending on an individual's needs, activity level and physical development, among other factors. Computer-assisted devices that adjust to different types of motion -- such as what Heather Mills McCartney used on the television program 'Dancing with the Stars' -- could cost $40,000 or higher.

Rush said Hanger may reap some financial benefits if insurance companies improve care and provide higher reimbursement payments, but it is mainly doing this to support its patients.

Amputee advocates estimate mandating amputee care in private plans would raise premiums by about 12 to 25 cents per member per month. They also say the insurance industry will save money in the long run because amputees with appropriate prosthetics would avoid other dangerous health conditions.

Mohit Ghose, spokesman for America's Health Insurance Plans -- which represents 1,300 companies, including UnitedHealth Group Inc. (NYSE:UNH) and Cigna Corp. (NYSE:CI) -- doesn't dispute the possible need for more prosthetic coverage, but said it must be weighed against other benefits in a health insurance plan.

'At what point does the benefit package become so large that the employer (OOTC:EPLI) can't afford to provide it and the average employee can't afford to pay their fair share of the premium?' he posed.

Rush said insurance companies are sometimes afraid that people will abuse a mandated health benefit, but he said that won't happen here.

'No one is going to cut off their arm or leg to access this benefit,' he said.

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Copyright 2007 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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