This bill amends Florida Statutes to enhance coverage for orthotics and prosthetics services for Medicaid recipients and individuals with health insurance. It authorizes the Agency for Health Care Administration to pay for specific orthotics and prosthetics services, requiring the agency to seek federal approval and amend contracts as necessary. The bill also creates new sections in the law that mandate individual health insurance policies, group health insurance policies, and health maintenance contracts to provide coverage for these services. Insurers are prohibited from denying claims for medically necessary orthotics and prosthetics under certain conditions and must submit annual reports detailing claims submitted and paid.

Key provisions include the requirement for coverage of orthoses and prostheses deemed medically necessary by the insured's provider, including replacements without regard to continuous use or lifetime restrictions. The bill specifies that health insurers and health maintenance organizations cannot deny claims for individuals with disabilities that would otherwise be covered for nondisabled individuals. The effective date for these changes is set for July 1, 2026, with annual reporting requirements beginning July 1, 2027.

Statutes affected:
S 1110 Filed: 409.906