Relating to: health insurance coverage of prosthetic limbs and custom orthotic braces. (FE)

SB 1077 requires health insurance plans - including self-insured plans operated by state/local governments - to cover prosthetic limbs and custom orthotic braces when medically necessary for daily activities, job functions, or bathing. It mandates coverage equal to federal standards (42 USC 1395k-1395m), including materials, repairs, and replacement without lifetime restrictions if repairs exceed 60% of replacement costs. The law applies to all covered individuals (enrollees in private plans or government self-insured plans) and requires insurers to provide written explanations for coverage denials based on medical necessity. It also ensures access to at least two in-network providers for these devices.