MA H1257

Requires all Massachusetts health insurers, including the Group Insurance Commission, MassHealth, HMOs, and preferred provider organizations, to cover medically necessary functional repair or restoration of craniofacial disorders caused by congenital disease or anomaly

Mandates coverage for treatment of specific genetic conditions: ectodermal dysplasia, dentinogenesis imperfecta, and amelogenesis imperfecta

Excludes purely cosmetic surgery and dental or orthodontic treatment unrelated to the congenital condition from required coverage

Prohibits insurers from imposing higher deductibles, coinsurance, copayments, or out-of-pocket limits for these treatments compared to other covered benefits

Cleft lip and cleft palate coverage is excluded from this mandate as it is already prescribed under existing law