LA HB477

Health coverage plans delivered, issued, or renewed in Louisiana on or after January 1, 2027 must provide coverage for prosthetic and custom orthotic devices and services at rates at least equal to Medicare coverage levels

Coverage must include multiple devices when medically necessary, including separate prosthetics/orthotics for physical activities (running, swimming, biking) and for bathing/showering, plus all materials, components, instruction, repair, and replacement

Medical necessity determinations rest with the enrollee's physician or advanced practice provider, and denials must be in writing with clear reasoning and are appealable under R.S. 22:3070

Insurers must maintain networks with at least two in-state prosthetic/orthotic providers and establish processes for out-of-network referrals when medically necessary services are unavailable in-network

Louisiana Medicaid must also provide coverage for prosthetic and custom orthotic devices and services when medically necessary, requiring the Department of Health to submit state plan amendments to CMS