Insurance; require health insurance policies to include coverage for medically necessary orthotic and prosthetic devices.

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To: Insurance
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Representatives Bell (65th), Summers,
Anthony

HOUSE BILL NO. 896

AN ACT TO REQUIRE CERTAIN HEALTH INSURANCE POLICIES AND 1
CONTRACTS TO PROVIDE COVERAGE FOR MEDICALLY NECESSARY ORTHOTIC 2
DEVICES AND PROSTHETIC DEVICES AND THEIR MATERIALS AND COMPONENTS; 3
TO DEFINE CERTAIN TERMS; TO REQUIRE THE COMMISSIONER OF INSURANCE 4
TO SUBMIT A REPORT TO THE HOUSE AND SENATE INSURANCE COMMITTEES 5
REGARDING THE IMPLEMENTATION OF COVERAGE UNDER THIS ACT; TO AMEND 6
SECTION 25-15-9, MISSISSIPPI CODE OF 1972, TO REQUIRE THE STATE 7
AND SCHOOL EMPLOYEES HEALTH INSURANCE PLAN TO INCLUDE COVERAGE FOR 8
MEDICALLY NECESSARY ORTHOTIC DEVICES AND PROSTHETIC DEVICES AND 9
THEIR MATERIALS AND COMPONENTS; AND FOR RELATED PURPOSES. 10
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 11
SECTION 1. (1) As used in this section, the following words 12
and phrases have the meanings given in this subsection unless the 13
context clearly requires otherwise: 14
(a) "Cost-sharing requirement" means a deductible, 15
coinsurance or copayment and any maximum limitation on the 16
application of the deductible, coinsurance, copayment or similar 17
out-of-pocket expense. 18
(b) "Covered person" means an individual covered under 19
a health benefit policy. 20
(c) "Health benefit policy" means an individual and 21
group health insurance policy providing coverage on an 22
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expense-incurred basis, an individual and group service or 23
indemnity type contract issued by a nonprofit corporation, an 24
individual and group service contract issued by a health 25
maintenance organization, a self-insured group arrangement to the 26
extent not preempted by federal law, and a managed health care 27
delivery entity of any type or description. 28
(d) "Health insurer" means a person, corporation or 29
other entity authorized to provide health benefit policies. 30
(e) "Medically necessary" means healthcare services 31
that a prudent physician or other healthcare provider would 32
provide, in accordance with nationally recognized clinical 33
practice guidelines, to a patient for the purpose of preventing, 34
diagnosing or treating an illness, injury or disease or its 35
symptoms in a manner that is: 36
(i) In accordance with generally accepted 37
standards of medical or other healthcare practice; 38
(ii) Clinically appropriate in terms of type, 39
frequency, extent, site and duration; 40
(iii) Not primarily for the economic benefit of 41
the health insurer or for the convenience of the patient, treating 42
physician or other healthcare provider; and 43
(iv) Not primarily custodial care, unless 44
custodial care is a covered service or benefit under the covered 45
person's healthcare plan. 46
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(f) "Nationally recognized clinical practice 47
guidelines" means evidence based clinical practice guidelines 48
developed by independent organizations or medical professional 49
societies utilizing a transparent methodology and reporting 50
structure and with a conflict of interest policy; the guidelines 51
must establish standards of care informed by a systematic review 52
of evidence and an assessment of the benefits and risks of 53
alternative care options, including recommendations intended to 54
optimize patient care. 55
(g) "Orthotic device" or "orthosis" means a custom 56
fabricated or custom fitted device that is designed, fabricated, 57
modified or fitted to correct, support or compensate for a 58
neuromusculoskeletal disorder or acquired condition for the 59
purpose of stabilizing, stretching or immobilizing a body part, 60
improving alignment, preventing deformities, protecting against 61
injury or assisting with motion or function, and is worn on the 62
outside of the body to help with such structural or functional 63
problems. The term does not include fabric or elastic supports, 64
corsets, arch supports, low-temperature plastic splints, trusses, 65
elastic hoses, canes, crutches, soft cervical collars, dental 66
appliances or other similar devices that are carried in stock and 67
sold as over-the-counter items by a drug store, department store, 68
corset shop or surgical supply facility. 69
(h) "Prosthetic device" or "prosthesis" means a custom 70
designed, fabricated, fitted, modified or fitted and modified 71
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device to replace an absent external body part for purposes of 72
restoring physiological function or cosmesis or both. The term 73
does not include: artificial eyes or ears; dental appliances; 74
cosmetic devices such as artificial breasts, eyelashes or wigs; or 75
other devices that do not have a significant impact on mobility or 76
the musculoskeletal functions of the body. 77
(2) A health benefit policy renewed or issued on or after 78
July 1, 2026, must include coverage for orthotic devices and 79
prosthetic devices that are medically necessary for: 80
(a) Activities of daily living; 81
(b) Essential job related activities; 82
(c) Personal hygiene related activities, including, but 83
not limited to, showering, bathing and toileting; or 84
(d) Physical activities, including, but not limited to, 85
running, biking, swimming and strength training, so as to maximize 86
the covered person's whole body health and both upper and lower 87
limb function. 88
(3) The coverage required under this section must include no 89
more than three (3) orthotic devices or prosthetic devices per 90
affected limb per covered person during any period of three (3) 91
years. The coverage must include: 92
(a) All materials and components for the use of the 93
orthotic device or prosthetic device, including: 94
(i) The orthosis or prosthesis; 95
(ii) Structural components such as the socket; 96
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(iii) Suspension mechanisms such as the pin, lock, 97
suction and elevated vacuum; 98
(iv) Hip joint, knee joint, foot, alignable parts 99
and terminal device; 100
(v) Connective components such as pads, bands and 101
cushions; and 102
(vi) Consumable items such as socks, sleeves and 103
liners; 104
(b) Formulation of the device's design, fabrication, 105
measurements and fittings; 106
(c) Education and training on using and maintaining the 107
device; and 108
(d) The repair of the device and its components. 109
(4) (a) The replacement of an orthotic device or prosthetic 110
device and its materials and components when the device is less 111
than three (3) years old must be deemed medically necessary if 112
there is adequate documentation of a change in the physiological 113
condition of the covered person, an irreparable change in the 114
condition of the device or any of its components, or the condition 115
of the device or a component of the device requires repairs and 116
the cost of those repairs would be more than sixty percent (60%) 117
of the cost of the device. 118
(b) A socket replacement must be deemed medically 119
necessary if there is adequate documentation of a physiological 120
need, including, but not limited to, a change in the residual 121
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limb, a functional need change, irreparable damage, or wear and 122
tear due to excessive weight of a covered person or physical 123
demands of an active covered person. 124
(c) A health insurer is not required to replace or 125
repair an orthotic device or prosthetic device due to misuse, 126
malicious damage, gross neglect, loss or theft. 127
(6) The coverage required under this section: 128
(a) Must be considered as habilitative or 129
rehabilitative benefits for purposes of any state or federal 130
requirements for coverage of essential health benefits; 131
(b) Must be comparable to coverage for other medical 132
and surgical benefits under the health benefit policy, including 133
restorative internal devices; 134
(c) May be subject to the same cost-sharing 135
requirements that apply to other medical devices and services 136
covered by the health benefit policy; however, the requirements 137
may not be solely applicable to this coverage; and 138
(d) May be limited, or the cost-sharing requirements 139
for the coverage may be altered for out-of-network providers; 140
however, any limitations may not be more restrictive than the 141
restrictions and requirements applicable to the out-of-network 142
coverage for the policy's medical or surgical coverage. 143
(7) This section may not be construed to prohibit a health 144
insurer from issuing or renewing a health benefit policy that 145
provides benefits greater than the minimum benefits required under 146
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this section or from issuing or renewing a policy that provides 147
benefits that generally are more favorable to the covered person 148
than those required under this section. 149
(8) Before July 1, 2032, the Commissioner of Insurance shall 150
submit a report to the Insurance Committees of the House of 151
Representatives and the Senate regarding the implementation of the 152
coverage required under this section. Each health insurer issuing 153
or renewing health benefit policies subject to this section shall 154
provide the Department of Insurance with all data requested by the 155
department for inclusion in the report, including, but limited to, 156
the total number of claims submitted, the total number of claims 157
paid, and the total amount of claims paid for the coverage 158
provided for by this section for policy years from 2026 to 2030. 159
(9) The Commissioner of Insurance shall promulgate rules and 160
regulations necessary to implement this section. 161
SECTION 2. Section 25-15-9, Mississippi Code of 1972, is 162
amended as follows: 163
25-15-9. (1) (a) The board shall design a plan of health 164
insurance for state employees that provides benefits for 165
semiprivate rooms in addition to other incidental coverages that 166
the board deems necessary. The amount of the coverages shall be 167
in such reasonable amount as may be determined by the board to be 168
adequate, after due consideration of current health costs in 169
Mississippi. The plan shall also include major medical benefits 170
in such amounts as the board determines. The plan shall provide 171
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for coverage for telemedicine services as provided in Section 172
83-9-351. The plan also must include coverage for medically 173
necessary orthotic devices and prosthetic devices and their 174
materials and components, as required under Section 1 of this act. 175
The board is also authorized to accept bids for such alternate 176
coverage and optional benefits as the board deems proper. The 177
board is authorized to accept bids for surgical services that 178
include assistance in locating a surgeon, setting up initial 179
consultation, travel, a negotiated single case rate bundle and 180
payment for orthopedic, spine, bariatric, cardiovascular and 181
general surgeries. The surgical services may only utilize 182
surgeons and facilities located in the State of Mississippi unless 183
otherwise provided by the board. Any contract for alternative 184
coverage and optional benefits shall be awarded by the board after 185
it has carefully studied and evaluated the bids and selected the 186
best and most cost-effective bid. The board may reject all of the 187
bids; however, the board shall notify all bidders of the rejection 188
and shall actively solicit new bids if all bids are rejected. The 189
board may employ or contract for such consulting or actuarial 190
services as may be necessary to formulate the plan, and to assist 191
the board in the preparation of specifications and in the process 192
of advertising for the bids for the plan. Those contracts shall 193
be solicited and entered into in accordance with Section 25-15-5. 194
The board shall keep a record of all persons, agents and 195
corporations who contract with or assist the board in preparing 196
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and developing the plan. The board in a timely manner shall 197
provide copies of this record to the members of the advisory 198
council created in this section and those legislators, or their 199
designees, who may attend meetings of the advisory council. The 200
board shall provide copies of this record in the solicitation of 201
bids for the administration or servicing of the self-insured 202
program. Each person, agent or corporation that, during the 203
previous fiscal year, has assisted in the development of the plan 204
or employed or compensated any person who assisted in the 205
development of the plan, and that bids on the administration or 206
servicing of the plan, shall submit to the board a statement 207
accompanying the bid explaining in detail its participation with 208
the development of the plan. This statement shall include the 209
amount of compensation paid by the bidder to any such employee 210
during the previous fiscal year. The board shall make all such 211
information available to the members of the advisory council and 212
those legislators, or their designees, who may attend meetings of 213
the advisory council before any action is taken by the board on 214
the bids submitted. The failure of any bidder to fully and 215
accurately comply with this paragraph shall result in the 216
rejection of any bid submitted by that bidder or the cancellation 217
of any contract executed when the failure is discovered after the 218
acceptance of that bid. The board is authorized to promulgate 219
rules and regulations to implement the provisions of this 220
subsection. 221
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The board shall develop plans for the insurance plan 222
authorized by this section in accordance with the provisions of 223
Section 25-15-5. 224
Any corporation, association, company or individual that 225
contracts with the board for the third-party claims administration 226
of the self-insured plan shall prepare and keep on file an 227
explanation of benefits for each claim processed. The explanation 228
of benefits shall contain such information relative to each 229
processed claim that the board deems necessary, and, at a minimum, 230
each explanation shall provide the claimant's name, claim number, 231
provider number, provider name, service dates, type of services, 232
amount of charges, amount allowed to the claimant and reason 233
codes. The information contained in the explanation of benefits 234
shall be available for inspection upon request by the board. The 235
board shall have access to all claims information utilized in the 236
issuance of payments to employees and providers. 237
(b) There is created an advisory council to advise the 238
board in the formulation of the State and School Employees Health 239
Insurance Plan. The council shall be composed of the * * * 240
Commissioner of Insurance, or his designee, an 241
employee-representative of the state institutions of higher 242
learning appointed by the board of trustees thereof, an 243
employee-representative of the Mississippi Department of 244
Transportation appointed by the director thereof, an 245
employee-representative of the Department of Revenue appointed by 246
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the Commissioner of Revenue, an employee-representative of 247
the * * * State Department of Health appointed by the State Health 248
Officer, an employee-representative of the Mississippi Department 249
of Corrections appointed by the Commissioner of Corrections, and 250
an employee-representative of the Department of Human Services 251
appointed by the Executive Director of Human Services, two 252
(2) * * * licensed public school administrators appointed by the 253
State Board of Education, two (2) * * * licensed classroom 254
teachers appointed by the State Board of Education, a * * * 255
nonlicensed school employee appointed by the State Board of 256
Education and a community * * * or junior college employee 257
appointed by the Mississippi Community College Board. 258
The Lieutenant Governor may designate the Secretary of the 259
Senate, the Chairman of the Senate Appropriations Committee, the 260
Chairman of the Senate Education Committee and the Chairman of the 261
Senate Insurance Committee, and the Speaker of the House of 262
Representatives may designate the Clerk of the House, the Chairman 263
of the House Appropriations Committee, the Chairman of the House 264
Education Committee and the Chairman of the House Insurance 265
Committee, to attend any meeting of the State and School Employees 266
Insurance Advisory Council. The appointing authorities may 267
designate an alternate member from their respective houses to 268
serve when the regular designee is unable to attend the meetings 269
of the council. Those designees shall have no jurisdiction or 270
vote on any matter within the jurisdiction of the council. For 271
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attending meetings of the council, the legislators shall receive 272
per diem and expenses, which shall be paid from the contingent 273
expense funds of their respective houses in the same amounts as 274
provided for committee meetings when the Legislature is not in 275
session; however, no per diem and expenses for attending meetings 276
of the council will be paid while the Legislature is in session. 277
No per diem and expenses will be paid except for attending 278
meetings of the council without prior approval of the proper 279
committee in their respective houses. 280
(c) No change in the terms of the State and School 281
Employees Health Insurance Plan may be made effective unless the 282
board, or its designee, has provided notice to the State and 283
School Employees Health Insurance Advisory Council and has called 284
a meeting of the council at least fifteen (15) days before the 285
effective date of the change. If the State and School Employees 286
Health Insurance Advisory Council does not meet to advise the 287
board on the proposed changes, the changes to the plan shall 288
become effective at such time as the board has informed the 289
council that the changes shall become effective. 290
(d) Medical benefits for retired employees and 291
dependents under age sixty-five (65) years and not eligible for 292
Medicare benefits. For employees who retire before July 1, 2005, 293
and for employees retiring due to work-related disability under 294
the Public Employees' Retirement System, the same health insurance 295
coverage as for all other active employees and their dependents 296
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shall be available to retired employees and all dependents under 297
age sixty-five (65) years who are not eligible for Medicare 298
benefits, the level of benefits to be the same level as for all 299
other active participants. For employees who retire on or after 300
July 1, 2005, and not retiring due to work-related disability 301
under the Public Employees' Retirement System, the same health 302
insurance coverage as for all other active employees and their 303
dependents shall be available to those retiring employees and all 304
dependents under age sixty-five (65) years who are not eligible 305
for Medicare benefits only if the retiring employees were 306
participants in the State and School Employees Health Insurance 307
Plan for four (4) years or more before their retirement, the level 308
of benefits to be the same level as for all other active 309
participants. This section will apply to those employees who 310
retire due to one hundred percent (100%) medical disability as 311
well as those employees electing early retirement. 312
(e) Medical benefits for retired employees and 313
dependents over age sixty-five (65) years or otherwise eligible 314
for Medicare benefits. For employees who retire before July 1, 315
2005, and for employees retiring due to work-related disability 316
under the Public Employees' Retirement System, the health 317
insurance coverage available to retired employees over age 318
sixty-five (65) years or otherwise eligible for Medicare benefits, 319
and all dependents over age sixty-five (65) years or otherwise 320
eligible for Medicare benefits, shall be the major medical 321
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coverage. For employees retiring on or after July 1, 2005, and 322
not retiring due to work-related disability under the Public 323
Employees' Retirement System, the health insurance coverage 324
described in this paragraph (e) shall be available to those 325
retiring employees only if they were participants in the State and 326
School Employees Health Insurance Plan for four (4) years or more 327
and are over age sixty-five (65) years or otherwise eligible for 328
Medicare benefits, and to all dependents over age sixty-five (65) 329
years or otherwise eligible for Medicare benefits. Benefits shall 330
be reduced by Medicare benefits as though the Medicare benefits 331
were the base plan. 332
All covered individuals shall be assumed to have full 333
Medicare coverage, Parts A and B; and any Medicare payments under 334
both Parts A and B shall be computed to reduce benefits payable 335
under this plan. 336
(f) Lifetime maximum: The lifetime maximum amount of 337
benefits payable under the health insurance plan for each 338
participant is Two Million Dollars ($2,000,000.00). 339
(2) Nonduplication of benefits — reduction of benefits by 340
Title XIX benefits: When benefits would be payable under more 341
than one (1) group plan, benefits under those plans will be 342
coordinated to the extent that the total benefits under all plans 343
will not exceed the total expenses incurred. 344
Benefits for hospital or surgical or medical benefits shall 345
be reduced by any similar benefits payable in accordance with 346
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Title XIX of the Social Security Act or under any amendments 347
thereto, or any implementing legislation. 348
Benefits for hospital or surgical or medical benefits shall 349
be reduced by any similar benefits payable by workers' 350
compensation. 351
No health care benefits under the state plan shall restrict 352
coverage for medically appropriate treatment prescribed by a 353
physician and agreed to by a fully informed insured, or if the 354
insured lacks legal capacity to consent by a person who has legal 355
authority to consent on his or her behalf, based on an insured's 356
diagnosis with a terminal condition. As used in this paragraph, 357
"terminal condition" means any aggressive malignancy, chronic 358
end-stage cardiovascular or cerebral vascular disease, or any 359
other disease, illness or condition which physician diagnoses as 360
terminal. 361
Not later than January 1, 2016, the state health plan shall 362
not require a higher co-payment, deductible or coinsurance amount 363
for patient-administered anti-cancer medications, including, but 364
not limited to, those orally administered or self-injected, than 365
it requires for anti-cancer medications that are injected or 366
intravenously administered by a health care provider, regardless 367
of the formulation or benefit category determination by the plan. 368
For the purposes of this paragraph, the term "anti-cancer 369
medications" has the meaning as defined in Section 83-9-24. 370
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(3) (a) Schedule of life insurance benefits — group term: 371
The amount of term life insurance for each active employee of a 372
department, agency or institution of the state government shall 373
not be in excess of One Hundred Thousand Dollars ($100,000.00), or 374
twice the amount of the employee's annual wage to the next highest 375
One Thousand Dollars ($1,000.00), whichever may be less, but in no 376
case less than Thirty Thousand Dollars ($30,000.00), with a like 377
amount for accidental death and dismemberment on a 378
twenty-four-hour basis. The plan will further contain a premium 379
waiver provision if a covered employee becomes totally and 380
permanently disabled before age sixty-five (65) years. Employees 381
retiring after June 30, 1999, shall be eligible to continue life 382
insurance coverage in an amount of Five Thousand Dollars 383
($5,000.00), Ten Thousand Dollars ($10,000.00) or Twenty Thousand 384
Dollars ($20,000.00) into retirement. 385
(b) Effective October 1, 1999, schedule of life 386
insurance benefits — group term: The amount of term life 387
insurance for each active employee of any school district, 388
community * * * or junior college, public library or 389
university-based program authorized under Section 37-23-31 for 390
deaf, aphasic and emotionally disturbed children or any regular 391
nonstudent bus driver shall not be in excess of One Hundred 392
Thousand Dollars ($100,000.00), or twice the amount of the 393
employee's annual wage to the next highest One Thousand Dollars 394
($1,000.00), whichever may be less, but in no case less than 395
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Thirty Thousand Dollars ($30,000.00), with a like amount for 396
accidental death and dismemberment on a twenty-four-hour basis. 397
The plan will further contain a premium waiver provision if a 398
covered employee of any school district, community * * * or junior 399
college, public library or university-based program authorized 400
under Section 37-23-31 for deaf, aphasic and emotionally disturbed 401
children or any regular nonstudent bus driver becomes totally and 402
permanently disabled before age sixty-five (65) years. Employees 403
of any school district, community * * * or junior college, public 404
library or university-based program authorized under Section 405
37-23-31 for deaf, aphasic and emotionally disturbed children or 406
any regular nonstudent bus driver retiring after September 30, 407
1999, shall be eligible to continue life insurance coverage in an 408
amount of Five Thousand Dollars ($5,000.00), Ten Thousand Dollars 409
($10,000.00) or Twenty Thousand Dollars ($20,000.00) into 410
retirement. 411
(4) Any eligible employee who on March 1, 1971, was 412
participating in a group life insurance program that has 413
provisions different from those included in this article and for 414
which the State of Mississippi was paying a part of the premium 415
may, at his discretion, continue to participate in that plan. The 416
employee shall pay in full all additional costs, if any, above the 417
minimum program established by this article. Under no 418
circumstances shall any individual who begins employment with the 419
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state after March 1, 1971, be eligible for the provisions of this 420
subsection. 421
(5) The board may offer medical savings accounts as defined 422
in Section 71-9-3 as a plan option. 423
(6) Any premium differentials, differences in coverages, 424
discounts determined by risk or by any other factors shall be 425
uniformly applied to all active employees participating in the 426
insurance plan. It is the intent of the Legislature that the 427
state contribution to the plan be the same for each employee 428
throughout the state. 429
(7) On October 1, 1999, any school district, community * * * 430
or junior college district or public library may elect to remain 431
with an existing policy or policies of group life insurance with 432
an insurance company approved by the State and School Employees 433
Health Insurance Management Board, in lieu of participation in the 434
State and School Life Insurance Plan. On or after July 1, 2004, 435
until October 1, 2004, any school district, community * * * or 436
junior college district or public library may elect to choose a 437
policy or policies of group life insurance existing on October 1, 438
1999, with an insurance company approved by the State and School 439
Employees Health Insurance Management Board in lieu of 440
participation in the State and School Life Insurance Plan. The 441
state's contribution of up to fifty percent (50%) of the active 442
employee's premium under the State and School Life Insurance Plan 443
may be applied toward the cost of coverage for full-time employees 444
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participating in the approved life insurance company group plan. 445
For purposes of this subsection (7), "life insurance company group 446
plan" means a plan administered or sold by a private insurance 447
company. After October 1, 1999, the board may assess charges in 448
addition to the existing State and School Life Insurance Plan 449
rates to such employees as a condition of enrollment in the State 450
and School Life Insurance Plan. In order for any life insurance 451
company group plan to be approved by the State and School 452
Employees Health Insurance Management Board under this subsection 453
(7), it shall meet the following criteria: 454
(a) The insurance company offering the group life 455
insurance plan shall be rated "A-" or better by A.M. Best state 456
insurance rating service and be licensed as an admitted carrier in 457
the State of Mississippi by the Mississippi Department of 458
Insurance. 459
(b) The insurance company group life insurance plan 460
shall provide the same life insurance, accidental death and 461
dismemberment insurance and waiver of premium benefits as provided 462
in the State and School Life Insurance Plan. 463
(c) The insurance company group life insurance plan 464
shall be fully insured, and no form of self-funding life insurance 465
by the company shall be approved. 466
(d) The insurance company group life insurance plan 467
shall have one (1) composite rate per One Thousand Dollars 468
($1,000.00) of coverage for active employees regardless of age and 469
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ST: Insurance; require health insurance
policies to include coverage for medically
necessary orthotic and prosthetic devices.
one (1) composite rate per One Thousand Dollars ($1,000.00) of 470
coverage for all retirees regardless of age or type of retiree. 471
(e) The insurance company and its group life insurance 472
plan shall comply with any administrative requirements of the 473
State and School Employees Health Insurance Management Board. If 474
any insurance company providing group life insurance benefits to 475
employees under this subsection (7) fails to comply with any 476
requirements specified in this subsection or any administrative 477
requirements of the board, the state shall discontinue providing 478
funding for the cost of that insurance. 479
SECTION 3. This act shall take effect and be in force from 480
and after July 1, 2026. 481