House Bill No. 6937 aims to amend the Medicaid state plan to provide coverage for medically necessary diapers for children aged three and younger. The bill defines "medical necessity" as a determination made by a licensed physician, physician assistant, or advanced practice registered nurse that diapers are essential to prevent or treat specific health conditions, including severe diaper dermatitis, urinary tract infections, or other skin diseases related to inadequate diaper hygiene, as well as developmental, psychiatric, or neurological conditions that may lead to unusual toileting needs. The bill mandates that the Commissioner of Social Services report by September 1, 2026, on the number of children eligible for this coverage, the associated costs, and potential savings from preventing health issues through access to diapers.

The bill will take effect on July 1, 2025, and is expected to incur a cost of at least $20 million annually to the state Medicaid program. This cost arises from the expansion of coverage for diapers, which are currently limited to 250 per month under existing Medicaid provisions. The bill does not delete any existing legal language but introduces new provisions to ensure that children with specific medical needs can receive necessary diaper coverage under Medicaid.