Bill > SB406

This bill requires the Maryland Medical Assistance Program and certain health insurance providers to provide comprehensive coverage for orthoses (custom-designed medical devices used to treat neuromuscular or musculoskeletal disorders) beginning January 1, 2026. The legislation mandates that insurers, health service plans, and health maintenance organizations must provide annual coverage for orthoses, their components, repairs, and replacements without imposing continuous use or lifetime restrictions. Importantly, replacements can be obtained if a healthcare provider determines they are necessary due to changes in the patient's physiological condition or irreparable damage to the orthosis. The bill also stipulates that orthosis coverage cannot have higher copayments or coinsurance than other medical benefits and cannot have separate annual or lifetime dollar maximums. Coverage is specifically designed to help patients complete daily living activities, job-related tasks, and physical activities like running, biking, and strength training. To ensure transparency, the bill requires insurance providers and managed care organizations to submit detailed reports to state agencies about orthosis claims between 2026 and 2029, with a comprehensive joint report to be submitted to legislative committees by December 31, 2031.

Budget and Finance

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/SB0406?ys=2025RS