HB 383 would expand Maryland health coverage requirements for orthoses under both the Maryland Medical Assistance Program and certain private health plans. The bill defines “orthosis” broadly as a custom designed, fabricated, molded, fitted, or modified device used to treat a neuromuscular or musculoskeletal disorder or acquired condition, and requires coverage for orthoses, components, repairs, and certain replacements. For private insurers, nonprofit health service plans, and HMOs, the bill would require coverage for these items on at least an annual basis, subject to the bill’s replacement rules and other coverage conditions.
The bill also limits how insurers may administer this coverage. It bars higher copayments or coinsurance than those applied to similar medical and surgical benefits, prohibits separate annual or lifetime dollar caps on orthoses coverage, and restricts medical necessity standards so they cannot be more restrictive than the Medicare Coverage Database. Coverage is also extended to orthoses deemed medically necessary for daily living, work-related activities, and physical activities such as running, biking, swimming, and strength training. For Medicaid managed care, the bill states that it should not be read to require coverage of additional HCPCS “L” codes beyond those covered as of December 31, 2025.
The bill would amend the Health – General Article and Insurance Article, adding a new coverage mandate in § 15-820 and updating the Maryland Medical Assistance Program’s required benefits in § 15-103. It would apply to policies, contracts, and health benefit plans issued, delivered, or renewed on or after January 1, 2026, and it would require reporting to the Maryland Insurance Administration and the Department of Health on claims and payments for the new coverage through calendar year 2029, with a joint report due to the legislature by December 31, 2031.
Because the available context shows the bill was withdrawn by the sponsor and no committee transcripts or votes are provided, there is no recorded floor or committee sentiment to assess from the supplied materials. Based on the bill text alone, the measure appears consumer- and patient-protective, aimed at improving access to orthotic devices and reducing out-of-pocket barriers for people who need them. The absence of recorded votes or discussion means any controversy is not documented in the provided record.
Notable points of potential contention in the bill itself include the breadth of the orthosis definition, the requirement to cover replacements without normal continuous-use or useful-life limits in certain circumstances, and the mandate that medical necessity standards track Medicare rather than narrower plan-specific criteria. Insurers and managed care organizations may also focus on the cost implications of expanded coverage, the prohibition on separate benefit caps, and the reporting requirements, while supporters would likely emphasize improved mobility, function, and access to medically necessary devices.
HB 383 would amend Maryland insurance and Medicaid law to require coverage of orthoses and related components, repairs, and replacements for both private health plans and the Maryland Medical Assistance Program. It would add a new statutory coverage mandate in the Insurance Article and a corresponding Medicaid benefit requirement in the Health – General Article, while also imposing cost-sharing, annual/lifetime limit, medical necessity, network, and reporting rules on covered entities. The bill would apply to policies and plans renewed or issued on or after January 1, 2026.
No committee testimony, vote tally, or recorded debate is provided, and the bill was ultimately withdrawn by the sponsor. Based on the text, the bill’s policy direction is strongly supportive of expanded access to orthotic care and appears designed to reduce coverage barriers for patients. The available record does not show organized opposition or support, but the structure of the bill suggests likely support from disability, patient advocacy, and mobility-access stakeholders, with possible concern from insurers and managed care organizations over cost and utilization controls.
The main likely points of contention are the scope of the new orthosis definition, the requirement to cover replacements even when normal wear-and-tear limits would otherwise apply, and the restriction that medical necessity standards cannot be more restrictive than Medicare’s coverage database. Insurers, nonprofit health plans, HMOs, and Medicaid managed care organizations may also object to the prohibition on separate annual or lifetime caps and the potential increase in claims costs, while supporters would argue these provisions are necessary to ensure meaningful access to medically necessary devices and repairs.