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EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
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SENATE BILL 276
J5, J1, J4 6lr1415
CF HB 445
By: Senators Beidle, Gile, and Hettleman
Introduced and read first time: January 19, 2026
Assigned to: Finance
Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: February 12, 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 c ertain insurers, 7
nonprofit health service plans, and health maintenance 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
(2023 Replacement Volume and 2025 Supplement) 22
2 SENATE BILL 276
BY adding to 1
Article – Health – General 2
Section 15–103(a)(2)(xxix) 3
Annotated Code of Maryland 4
(2023 Replacement Volume and 2025 Supplement) 5
BY repealing and reenacting, with amendments, 6
Article – Insurance 7
Section 15–820 and 15–844(g) 8
Annotated Code of Maryland 9
(2017 Replacement Volume and 2025 Supplement) 10
BY repealing and reenacting, without amendments, 11
Article – Insurance 12
Section 15–844(a) through (c) 13
Annotated Code of Maryland 14
(2017 Replacement Volume and 2025 Supplement) 15
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 16
That the Laws of Maryland read as follows: 17
Article – Health – General 18
15–103. 19
(a) (1) The Secretary shall administer the Maryland Medical Assistance 20
Program. 21
(2) The Program: 22
(xxvii) Beginning on January 1, 2026, if providing coverage for the 23
delivery of anesthesia, shall provide coverage for the delivery of anesthesia in accordance 24
with § 15–862 of the Insurance Article; [and] 25
(xxviii) Beginning on January 1, 2026, shall provide calcium score 26
testing in accordance with § 15–863 of the Insurance Article; AND 27
(XXIX) BEGINNING ON JANUARY 1, 2027, SHALL PROVIDE 28
COVERAGE FOR ORTHOSE S IN ACCORDANCE WITH § 15–820 OF THE INSURANCE 29
ARTICLE. 30
Article – Insurance 31
15–820. 32
SENATE BILL 276 3
(a) (1) In this 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 I NSURANCE 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 SECTION SHALL PROVID E 28
COVERAGE FOR REPLACEMENTS OF ORTHOSES WITHOUT REGARD TO CONTINUOUS 29
USE OR USEFUL LIFETIME RESTRICTIONS IF AN ORDERING HEALTH CARE PROVIDER 30
DETERMINES THAT THE PROVISION OF A REPLA CEMENT ORTHOSIS OR A 31
REPLACEMENT COMPONENT OF THE ORTHOSIS IS NECESSARY: 32
4 SENATE BILL 276
(I) BECAUSE OF A CHANGE IN THE PHYSIOLOGICAL CONDITION 1
OF THE PATIENT; OR 2
(II) UNLESS NECESSITATED BY MISUSE , BECAUSE OF AN 3
IRREPARABLE CHANGE IN THE CONDITION OF THE ORTHOSIS OR A COMPONENT OF 4
THE ORTHOSIS. 5
(2) AN ENTITY SUBJ ECT TO THIS SECTION MAY REQUIRE AN 6
ORDERING HEALTH CARE PROVIDER TO CONFIRM THAT THE ORTHOSIS OR 7
COMPONENT OF THE ORT HOSIS BEING REPLACED MEETS THE REQUIREMEN TS OF 8
PARAGRAPH (1) OF THIS SUBSECTION I F THE ORTHOSIS OR CO MPONENT OF THE 9
ORTHOSIS IS LESS THAN 1 YEAR OLD. 10
(E) THE COVERED BENEFITS UNDER THIS SECTION M AY NOT BE SUBJECT 11
TO A HIGHER COPAYMENT OR COINSURANCE REQUIREMENT THAN THE COPAYMENT 12
OR COINSURANCE FOR O THER SIMILAR MEDICAL AND SURGICAL BENEFIT S 13
COVERED UNDER THE POLICY OR CONTRACT OF THE INSURED OR ENROLLEE. 14
(F) AN ENTITY SUBJECT TO THIS SECTION MAY NOT IMPOSE AN ANNUAL OR 15
LIFETIME DOLLAR MAXI MUM ON COVERAGE REQU IRED UNDER THIS SECT ION 16
SEPARATE FROM ANY AN NUAL OR LIFETIME DOL LAR MAXIMUM THAT APP LIES IN 17
THE AGGREGATE TO ALL COVERED BENEFITS UNDER THE POLICY OR CONTRACT OF 18
THE INSURED OR ENROLLEE. 19
(G) (1) AN ENTITY SUBJECT TO THIS SECTION MAY NOT ESTABLISH 20
REQUIREMENTS FOR MED ICAL NECESSITY OR AP PROPRIATENESS FOR TH E 21
COVERAGE REQUIRED UN DER THIS SECTION THA T ARE MORE RESTRICTI VE THAN 22
THE INDIC ATIONS AND LIMITATIO NS OF COVERAGE AND M EDICAL NECESSITY 23
ESTABLISHED UNDER THE MEDICARE COVERAGE DATABASE. 24
(2) THE COVERED BENEFITS UNDER THIS SECTION I NCLUDE ALL 25
ORTHOSES DETERMINED BY A TREATING HEALTH CARE PROVIDER TO BE 26
MEDICALLY NECESSARY FOR: 27
(I) COMPLETING ACTIVITIES OF DAILY LIVING; 28
(II) ESSENTIAL JOB–RELATED ACTIVITIES; OR 29
(III) PERFORMING PHYSICAL ACTIVITIES INCLUDING RUNNING, 30
BIKING, SWIMMING, STRENGTH TRAINING , AND OTHER ACTIVITIES TO MAXIMIZE 31
THE WHOLE–BODY HEALTH AND LOWER OR UPPER LIMB FUNCTION OF THE INSURED 32
OR ENROLLEE. 33
SENATE BILL 276 5
(H) AN ENTITY SUBJECT TO THIS SECTION THAT US ES A PROVIDER PANEL 1
FOR A POLICY OR CONTRACT DESCRIBED IN SUBSECTION (B) OF THIS SECTION AND 2
THE PROVISION OF COVERED BENEFITS UNDER THIS SECTION SHALL COMPLY WITH 3
§ 15–112(B)(3) OF THIS TITLE. 4
15–844. 5
(a) (1) In this section, “prosthesis” means an artificial device to replace, in 6
whole or in part, a leg, an arm, or an eye. 7
(2) “Prosthesis” includes a custom –designed, –fabricated, –fitted, 8
or –modified device to treat partial or total limb loss for purposes of restoring physiological 9
function. 10
(b) This section applies to: 11
(1) insurers and nonprofit health service plans that provide hospital, 12
medical, or surgical benefits to individuals or groups on an exp ense–incurred basis under 13
health insurance policies or contracts that are issued or delivered in the State; and 14
(2) health maintenance organizations that provide hospital, medical, or 15
surgical benefits to individuals or groups under contracts that are i ssued or delivered in 16
the State. 17
(c) An entity subject to this section shall provide once annually coverage for: 18
(1) prostheses; 19
(2) components of prostheses; 20
(3) repairs to prostheses; and 21
(4) subject to subsection (d) of this section, replacements of prostheses or 22
prosthesis components. 23
(g) (1) An entity subject to this section may not establish requirements for 24
medical necessity or appropriateness for the coverage required under this section that are 25
more restrictive than the indicat ions and limitations of coverage and medical necessity 26
established under the Medicare Coverage Database. 27
(2) The covered benefits under this section include ALL prostheses 28
determined by a treating health care provider to be medically necessary for: 29
(i) completing activities of daily living; 30
6 SENATE BILL 276
(ii) essential job–related activities; or 1
(iii) performing physical activities, including running, biking, 2
swimming, strength training, and other activities to maximize the whole–body health and 3
lower or upper limb function of the insured or enrollee. 4
SECTION 2. AND BE IT FURTHER ENACTED, That it is the intent of the General 5
Assembly that Section 1 of this Act may not be construed to require managed care 6
organizations under the Maryland Medical Assistanc e Program to cover additional 7
Healthcare Common Procedure Coding System (HCPCS) “L” codes for orthotic procedures 8
and devices than are covered by managed care organizations as of December 31, 2026. 9
SECTION 3. AND BE IT FURTHER ENACTED, That: 10
(a) On or before June 30, 2032, each entity that is subject to § 15 –820 of the 11
Insurance Article, as enacted by Section 1 of this Act, and each managed care organization 12
providing coverage under the Maryland Medical Assistance Program shall report to the 13
Maryland Insurance Administration and the Maryland Department of Health, respectively, 14
on its compliance with § 15 –820 of the Insurance Article or § 15 –103(a)(2)(xxix) of the 15
Health – General Article, as enacted by Section 1 of this Act, and, as applicable, for calendar 16
years 2027 through 2030. 17
(b) (1) The Maryland Insurance Administration and the Maryland 18
Department of Health shall jointly prescribe the form for the report required under 19
subsection (a) of this section. 20
(2) The form must include the number of cl aims and the total amount of 21
claims paid in the State for the coverage required by § 15–820 of the Insurance Article or § 22
15–103(a)(2)(xxix) of the Health – General Article, as enacted by Section 1 of this Act, and 23
as applicable. 24
(c) (1) The Maryland Ins urance Administration and the Maryland 25
Department of Health shall aggregate the data required under subsection (b) of this section 26
in a joint report by calendar year. 27
(2) On or before December 31, 2032, the Maryland Insurance 28
Administration and the Maryland Department of Health shall submit the joint report to 29
the Senate Finance Committee and the House Health and Government Operations 30
Committee, in accordance with § 2–1257 of the State Government Article. 31
SECTION 4. AND BE IT FURTHER ENACTED, That Section 1 of this Act shall 32
apply to all policies, contracts, and health benefit plans issued, delivered, or renewed in the 33
State on or after January 1, 2027. 34
SECTION 5. AND BE IT FURTHER ENACTED, That this Act shall take effect 35
January 1, 2027. 36