FL H1301

Requires individual health insurance policies, group/blanket/franchise policies, and health maintenance contracts issued or renewed on or after July 1, 2026, to cover orthoses and prostheses deemed medically necessary for daily living, job-related activities, and physical recreational activities

Mandates coverage for replacements without continuous use or useful lifetime restrictions when medically necessary due to changes in the patient's physiological condition, irreparable device damage, or when repairs would exceed 60% of replacement cost

Prohibits insurers from denying orthotic/prosthetic claims for individuals with limb loss or absence when equivalent coverage would be provided to nondisabled persons seeking treatment to restore the same physical function

Authorizes the Agency for Health Care Administration to pay for orthotics and prosthetics services for Medicaid recipients, including the device, materials, instruction, and necessary repairs or replacements

Requires health insurers and HMOs to submit annual reports to the Office of Insurance Regulation beginning July 1, 2027, detailing total claims submitted and paid for orthotics and prosthetics services