IN SB0072

Requires state employee health plans, accident and sickness insurance policies, and HMO contracts to cover orthotic devices (custom braces/supports) and prosthetic devices (artificial arms/legs) that providers determine meet medical needs for daily activities, physical activities like running and swimming, and bathing/showering

Mandates coverage for all materials, components, instruction, and medically necessary repairs/replacements of devices, with replacement allowed regardless of "useful lifetime" restrictions when physiological changes occur, devices become irreparable, or repair costs exceed 60% of replacement cost

Prohibits denial of coverage based on actual or perceived disability and requires insurers to maintain at least two distinct orthotic/prosthetic providers in-network, with out-of-network referral processes if medically necessary devices are unavailable in-network

Sets reimbursement equal to federal Medicare rates unless different rates are negotiated, and classifies coverage as habilitative/rehabilitative benefits for essential health benefit requirements

Requires state personnel department, insurers, and HMOs to report total claims and amounts paid for these devices to the insurance commissioner by October 1, 2027, with aggregated data due to legislative insurance committees by December 1, 2027; effective July 1, 2026