Senate Bill 1077 mandates that health insurance policies and self-insured governmental health plans provide coverage for prosthetic limbs and custom orthotic braces when deemed medically necessary. The bill outlines that coverage must include all necessary materials, components, and related services for the use of these devices, as well as instruction on their use and reasonable repair costs. Additionally, it stipulates that significant repairs or replacements must be covered without restrictions related to continuous use or the device's useful lifetime, particularly when medically necessary due to changes in the individual's condition or if repair costs exceed 60% of the replacement cost. The coverage must at least match the standards set by the federal Medicare program.

Furthermore, the bill requires managed care plans to ensure access to necessary clinical care and devices from at least two in-network providers. If in-network services are unavailable, the plan must facilitate referrals to out-of-network providers and ensure full reimbursement at a mutually agreed rate. The legislation also includes provisions for normal utilization management and prior authorization practices, with specific requirements for written explanations in cases of coverage denial based on medical necessity. The act will take effect four months after publication and applies to policy years beginning on or after its effective date, with considerations for collective bargaining agreements.