Group Health Plan Prosthetics Parity Act of 2007

To provide parity under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and components and benefits for other medical and surgical services.

3/13/2008--Introduced.
Group Health Plan Prosthetics Parity Act of 2007 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to require a group health plan that provides both medical and surgical benefits and benefits for prosthetic devices and components to provide prosthetics coverage under terms and conditions that are no less favorable than those applicable to substantially all medical and surgical benefits provided under the plan.
Prohibits the prosthetics benefit from being subject to separate or more restrictive financial requirements or more restrictive treatment limitations.
Applies the requirements of this Act separately with respect to in-network and out-of-network benefits.
Requires a group health plan to apply the same prior authorization requirements to the prosthetics benefit as apply for all similar benefits under the plan.
Limits the required prosthetics benefit to the most appropriate model that adequately meets the medical requirements of the patient. Includes repair or replacement of prosthetic devices and components within such coverage.
Prohibits a group health plan from imposing any annual or lifetime dollar limitation on the prosthetics benefit that is not applied in the aggregate to all medical and surgical benefits provided under the plan.
Requires the Secretary of Labor to:
(1) assist participants and beneficiaries with any questions or problems regarding compliance with the requirements of this Act; and
(2) conduct random audits of group health plans to ensure compliance.
Requires the Comptroller General to evaluate the effects of this Act, including on the cost of and access to heath insurance coverage.


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Sponsor

• Rep. Robert Andrews [D, NJ-1]
• and 17 Co-Sponsors
  • Rep. Bruce Braley [D, IA-1]
  • Rep. André Carson [D, IN-7]
  • Rep. William Clay [D, MO-1]
  • Rep. Lincoln Diaz-Balart [R, FL-21]
  • Rep. Mario Diaz-Balart [R, FL-25]
  • Rep. Michael Doyle [D, PA-14]
  • Rep. Bob Filner [D, CA-51]
  • Rep. Raul Grijalva [D, AZ-7]
  • Rep. Peter King [R, NY-3]
  • Rep. Carolyn Maloney [D, NY-14]
  • Rep. George Miller [D, CA-7]
  • Rep. Jerrold Nadler [D, NY-8]
  • Rep. Donald Payne [D, NJ-10]
  • Rep. Todd Platts [R, PA-19]
  • Rep. Zach Wamp [R, TN-3]
  • Rep. Maxine Waters [D, CA-35]
  • Rep. Peter Welch [D, VT-0]
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Committees

• House Education and Labor

Amendments

This bill has no amendments.

Amendments to H.R.5615

Number	Status	Purpose

Bill Status

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Introduced		Voted on by House		Voted on by Senate		Considered By President		Bill Becomes Law
March 13, 2008

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All Bill Actions

• Mar 13, 2008: Referred to the House Committee on Education and Labor.
• Introduced on Mar 13, 2008.

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Blog Coverage

June 03, 2008 Curious Campaign Contribution and Vote Sponsorship Connection

Yesterday, Dan Christensen had a report in The Miami Herald about two Florida Congressmen who are also brothers, Lincoln and Mario Diaz-Balart, receiving $7100 and $3000 respectfully from a Maryland company weeks and days before they ...

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Source: Sunlight Foundation blogs

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June 03, 2008 Curious Campaign Contribution and Vote Sponsorship Connection

... and days before they signed on to be cosponsors of a bill prized by the company – the Hanger Orthopedic Group (HOG), a Bethesda, Md., -based prosthetics company, is pushing the Group Health Plan Prosthetics Parity Act (HR 5615). ...

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Source: Sunlight Foundation Blogs

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June 02, 2008 Diaz-Balarts back bill after donation

Jersey Senate seat. The Diaz-Balarts, traditionally not healthcare leaders on Capitol Hill, stand out from ... million. If approved next year, the Group Health Plan Prosthetics Parity Act, HR 5615, would ...

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Source: Inbox Robot: Healthcare Lobbying News

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