H.B. No. 426 is a legislative act that mandates coverage and reimbursement for childhood cranial remolding orthosis under the Medicaid and child health plan programs in Texas. The bill introduces a new section, 62.1512, to the Health and Safety Code, which requires the child health plan to fully cover the cost of cranial remolding orthosis for enrollees, aligning it with the Medicaid coverage provided under Section 32.03126 of the Human Resources Code. Additionally, Section 32.03126 is added to the Human Resources Code, defining cranial remolding orthosis and stipulating that medical assistance reimbursement must cover the full cost for children diagnosed with specific conditions, such as craniosynostosis or certain types of plagiocephaly and brachycephaly, provided they meet certain age and treatment criteria.

The bill ensures that the coverage for cranial remolding orthosis is at least as favorable as that for other orthotics under the medical assistance program. It also includes a provision that allows state agencies to delay implementation of any part of the act if a federal waiver or authorization is required. The act is set to take effect on September 1, 2025.

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