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EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb0445*
HOUSE BILL 445
J5, J1, J4 6lr1841
CF SB 276
By: Delegates Martinez, Acevero, Cullison, and Young Young, Alston, Bagnall ,
Guzzone, Hill, Hutchinson, S. Johnson, Kaufman, Kipke, Lopez, Reilly,
Rosenberg, Ross, Taveras, White Holland, and Woorman
Introduced and read first time: January 23, 2026
Assigned to: Health
Committee Report: Favorable with amendments
House action: Adopted
Read second time: February 18, 2026
CHAPTER ______
AN ACT concerning 1
Maryland Medical Assistance Program and Health Insurance – Coverage for 2
Orthoses and Prostheses 3
(So Every Body Can Move Act) 4
FOR the purpose of requiring the Maryland Medical Assistance Program and certain 5
insurers, nonprofit health service plans, and health maintenance organizations to 6
provide certain coverage related to orthoses; establishing that certain insurers, 7
nonprofit health service plans, and health maintenanc e organizations must comply 8
with certain provider network requirements; clarifying that certain mandated 9
benefits related to prostheses include all prostheses determined by a treating health 10
care provider to be medically necessary for certain purposes; and generally relating 11
to coverage and reimbursement for orthoses and prostheses. 12
BY repealing and reenacting, without amendments, 13
Article – Health – General 14
Section 15–103(a)(1) 15
Annotated Code of Maryland 16
(2023 Replacement Volume and 2025 Supplement) 17
BY repealing and reenacting, with amendments, 18
Article – Health – General 19
Section 15–103(a)(2)(xxvii) and (xxviii) 20
Annotated Code of Maryland 21
2 HOUSE BILL 445
(2023 Replacement Volume and 2025 Supplement) 1
BY adding to 2
Article – Health – General 3
Section 15–103(a)(2)(xxix) 4
Annotated Code of Maryland 5
(2023 Replacement Volume and 2025 Supplement) 6
BY repealing and reenacting, with amendments, 7
Article – Insurance 8
Section 15–820 and 15–844(g) 9
Annotated Code of Maryland 10
(2017 Replacement Volume and 2025 Supplement) 11
BY repealing and reenacting, without amendments, 12
Article – Insurance 13
Section 15–844(a) through (c) 14
Annotated Code of Maryland 15
(2017 Replacement Volume and 2025 Supplement) 16
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 17
That the Laws of Maryland read as follows: 18
Article – Health – General 19
15–103. 20
(a) (1) The Secretary shall administer the Maryland Medical Assistance 21
Program. 22
(2) The Program: 23
(xxvii) Beginning on January 1, 2026, if providing coverage for the 24
delivery of anesthesia, shall provide coverage for the delivery of anesthesia in accordance 25
with § 15–862 of the Insurance Article; [and] 26
(xxviii) Beginning on January 1, 2026, shall provide calcium score 27
testing in accordance with § 15–863 of the Insurance Article; AND 28
(XXIX) BEGINNING ON JANUARY 1, 2027, SHALL PROVIDE 29
COVERAGE FOR ORTHOSE S IN ACCORDANCE WITH § 15–820 OF THE INSURANCE 30
ARTICLE. 31
Article – Insurance 32
15–820. 33
HOUSE BILL 445 3
(a) (1) In th is section, [“orthopedic brace” ] “ORTHOSIS” means a rigid or 1
semi–rigid device that is used to: 2
[(1)] (I) support a weak or [deformed] MISALIGNED body member; or 3
[(2)] (II) restrict or eliminate motion [in a diseased or injured part of the 4
body], IMPROVE FUNCTION, OR RELIEVE SYMPTOMS OF A DISEASE, AN INJURY, OR A 5
POST–OPERATIVE CONDITION IN A PART OF THE BODY. 6
(2) “ORTHOSIS” INCLUDES A CUSTOM –DESIGNED, 7
CUSTOM–FABRICATED, CUSTOM–MOLDED, CUSTOM–FITTED, OR MODIFIED DEVICE 8
TO TREAT A NEUROMUSC ULAR OR, MUSCULOSKELETAL DISORDER OR, ACQUIRED, 9
OR CONGENITAL CONDITION. 10
(B) THIS SECTION APPLIES TO: 11
(1) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT 12
PROVIDE HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUPS 13
ON AN EXPENSE –INCURRED BASIS UNDER HEALTH INSURAN CE POLICIES OR 14
CONTRACTS THAT ARE ISSUED OR DELIVERED IN THE STATE; AND 15
(2) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 16
HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUPS UNDER 17
CONTRACTS THAT ARE ISSUED OR DELIVERED IN THE STATE. 18
[(b)] (C) [Each health insurance contract that is delivered or issued for delivery 19
in the State by a nonprofit health service plan and that provides hospital benefits ] AN 20
ENTITY SUBJECT TO THIS SECTION shall provide [benefits for orthopedic braces] ONCE 21
ANNUALLY COVERAGE FOR: 22
(1) ORTHOSES; 23
(2) COMPONENTS OF ORTHOSES; 24
(3) REPAIRS TO ORTHOSES; AND 25
(4) SUBJECT TO SUBSECTION (D) OF THIS SECTION, REPLACEMENTS 26
OF ORTHOSES OR ORTHOSIS COMPONENTS. 27
(D) (1) AN ENTITY SUBJECT TO THIS SECT ION SHALL PROVIDE 28
COVERAGE FOR REPLACEMENTS OF ORTHOSES WITHOUT REGARD TO CONTINUOUS 29
USE OR USEFUL LIFETIME RESTRICTIONS IF AN ORDERING HEALTH CARE PROVIDER 30
4 HOUSE BILL 445
DETERMINES THAT THE PROVISION OF A REPLA CEMENT ORTHOSIS OR A 1
REPLACEMENT COMPONENT OF THE ORTHOSIS IS NECESSARY: 2
(I) BECAUSE OF A CHANGE IN THE PHYSIOLOGICAL CONDITION 3
OF THE PATIENT; OR 4
(II) UNLESS NECESSITATED BY MISUSE , BECAUSE OF AN 5
IRREPARABLE CHANGE IN THE CONDITION OF THE ORTHOSIS OR A COMPONENT OF 6
THE ORTHOSIS. 7
(2) AN ENTITY SUBJECT T O THIS SECTION MAY R EQUIRE AN 8
ORDERING HEALTH CARE PROVIDER TO CONFIRM THAT THE ORTHOSIS OR 9
COMPONENT OF THE ORT HOSIS BEING REPLACED MEETS THE REQUIREMEN TS OF 10
PARAGRAPH (1) OF THIS SUBSECTION I F THE ORTHOSIS OR CO MPONENT OF THE 11
ORTHOSIS IS LESS THAN 1 YEAR OLD. 12
(E) THE COVERED BENEFITS UNDER THIS SECTION M AY NOT BE SUBJECT 13
TO A HIGHER COPAYMENT OR COINSURANCE REQUIREMENT THAN THE COPAYMENT 14
OR COINSURANCE FOR O THER SIMILAR MEDICAL AND SURGICAL BENEFIT S 15
COVERED UNDER THE POLICY OR CONTRACT OF THE INSURED OR ENROLLEE. 16
(F) AN ENTITY SUBJECT TO THIS SECTION MAY NOT IMPOSE AN ANNUAL OR 17
LIFETIME DOLLAR MAXI MUM ON COVERAGE REQU IRED UNDER THIS SECT ION 18
SEPARATE FROM ANY AN NUAL OR LIFETIME DOL LAR MAXIMUM THAT APP LIES IN 19
THE AGGREGATE TO ALL COVERED BENEFITS UNDER THE POLICY OR CONTRACT OF 20
THE INSURED OR ENROLLEE. 21
(G) (1) AN ENTITY SUBJECT TO THIS SECTION MAY NOT ESTABLISH 22
REQUIREMENTS FOR MED ICAL NECESSITY OR AP PROPRIATENESS FOR TH E 23
COVERAGE REQUIRED UN DER THIS SECTION THA T ARE MORE RESTRICTI VE THAN 24
THE INDICATIONS AND LIMI TATIONS OF COVERAGE AND MEDICAL NECESSIT Y 25
ESTABLISHED UNDER THE MEDICARE COVERAGE DATABASE. 26
(2) THE COVERED BENEFITS UNDER THIS SECTION I NCLUDE ALL 27
ORTHOSES DETERMINED BY A TREATING HEALTH CARE PROVIDER TO BE 28
MEDICALLY NECESSARY FOR: 29
(I) COMPLETING ACTIVITIES OF DAILY LIVING; 30
(II) ESSENTIAL JOB–RELATED ACTIVITIES; OR 31
(III) PERFORMING PHYSICAL ACTIVITIES INCLUDING RUNNING, 32
BIKING, SWIMMING, STRENGTH TRAINING , AND OTHER ACTIVITIES TO MAXIMIZE 33
HOUSE BILL 445 5
THE WHOLE–BODY HEALTH AND LOWER OR UPPER LIMB FUNCTION OF THE INSURED 1
OR ENROLLEE. 2
(H) AN ENTITY SUBJECT TO THIS SECTION THAT US ES A PROVIDER PANEL 3
FOR A POLICY OR CONTRACT DESCRIBED IN SUBSECTION (B) OF THIS SECTION AND 4
THE PROVISION OF COVERED BENEFITS UNDER THIS SECTION SHALL COMPLY WITH 5
§ 15–112(B)(3) OF THIS TITLE. 6
15–844. 7
(a) (1) In this section, “prosthesis” means an artificial device to replace, in 8
whole or in part, a leg, an arm, or an eye. 9
(2) “Prosthesis” includes a custom –designed, –fabricated, –fitted, or 10
–modified device to treat partial or total limb loss for purposes of restoring physiological 11
function. 12
(b) This section applies to: 13
(1) insurers and nonprofit health service plans that provide hospital, 14
medical, or surgical benefits to individuals or groups on a n expense–incurred basis under 15
health insurance policies or contracts that are issued or delivered in the State; and 16
(2) health maintenance organizations that provide hospital, medical, or 17
surgical benefits to individuals or groups under contracts that are issued or delivered in 18
the State. 19
(c) An entity subject to this section shall provide once annually coverage for: 20
(1) prostheses; 21
(2) components of prostheses; 22
(3) repairs to prostheses; and 23
(4) subject to subsection (d) of this section, replacements of prostheses or 24
prosthesis components. 25
(g) (1) An entity subject to this section may not establish requirements for 26
medical necessity or appropriateness for the coverage required under this section that are 27
more restrictive than the indicat ions and limitations of coverage and medical necessity 28
established under the Medicare Coverage Database. 29
(2) The covered benefits under this section include ALL prostheses 30
determined by a treating health care provider to be medically necessary for: 31
6 HOUSE BILL 445
(i) completing activities of daily living; 1
(ii) essential job–related activities; or 2
(iii) performing physical activities, including running, biking, 3
swimming, strength training, and other activities to maximize the whole–body health and 4
lower or upper limb function of the insured or enrollee. 5
SECTION 2. AND BE IT FURTHER ENACTED, That it is the intent of the General 6
Assembly that Section 1 of this Act may not be construed to require managed care 7
organizations under the Maryland Medical Assistance Program to cover additional 8
Healthcare Common Procedure Coding System (HCPCS) “L” codes for orthotic procedures 9
and devices than are covered by managed care organizations as of December 31, 2026. 10
SECTION 3. AND BE IT FURTHER ENACTED, That: 11
(a) On or b efore June 30, 2032, each entity that is subject to § 15 –820 of the 12
Insurance Article, as enacted by Section 1 of this Act, and each managed care organization 13
providing coverage under the Maryland Medical Assistance Program shall report to the 14
Maryland Insurance Administration and the Maryland Department of Health, respectively, 15
on its compliance with § 15 –820 of the Insurance Article or § 15 –103(a)(2)(xxix) of the 16
Health – General Article, as enacted by Section 1 of this Act, and, as applicable, for calendar 17
years 2027 through 2030. 18
(b) (1) The Maryland Insurance Administration and the Maryland 19
Department of Health shall jointly prescribe the form for the report required under 20
subsection (a) of this section. 21
(2) The form must include the number of cla ims and the total amount of 22
claims paid in the State for the coverage required by § 15–820 of the Insurance Article or § 23
15–103(a)(2)(xxix) of the Health – General Article, as enacted by Section 1 of this Act, and 24
as applicable. 25
(c) (1) The Maryland Insurance Administration and the Maryland 26
Department of Health shall aggregate the data required under subsection (b) of this section 27
in a joint report by calendar year. 28
(2) On or before December 31, 2032, the Maryland Insurance 29
Administration and the M aryland Department of Health shall submit the joint report to 30
the Senate Finance Committee and the House Health and Government Operations 31
Committee, in accordance with § 2–1257 of the State Government Article. 32
SECTION 4. AND BE IT FURTHER ENACTED, That S ection 1 of this Act shall 33
apply to all policies, contracts, and health benefit plans issued, delivered, or renewed in the 34
State on or after January 1, 2027. 35
HOUSE BILL 445 7
SECTION 5. AND BE IT FURTHER ENACTED, That this Act shall take effect 1
January 1, 2027. 2
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.