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LouisianaHB 12352026 Regular SessionHouseWALLET

INSURANCE/HEALTH: Modifies provisions of law regarding health insurance coverage of prosthetic and custom orthotic devices and services (EN INCREASE EX See Note)

Sponsored By: Troy Jude Hebert (Republican)

Signed by Governor

Insurance

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Bill Overview

Analyzed Economic Effects

4 provisions identified: 3 benefits, 0 costs, 1 mixed.

Medicaid covers needed limbs and braces

Louisiana Medicaid must cover medically necessary artificial limbs, custom limb braces, and related services for enrolled members. Coverage includes materials, parts, instruction, repairs, and replacements. It includes care needed to restore or maintain daily activities, essential job tasks, and physical activity. Medical need is determined under Louisiana Medicaid's standards and clinical criteria. The supplied provisions do not specify a Medicaid start date.

More insurance coverage for artificial limbs

Starting January 1, 2027, covered Louisiana health plans must cover medically necessary artificial limbs, custom limb braces, and related services. Existing plans must comply at renewal, no later than January 1, 2028; limited-benefit and short-term plans are excluded. Coverage and payment rates must at least match the specified Medicare standards. Plans determine medical need in consultation with treating clinicians, considering medical history, limb condition, prior devices, function, and personal goals. Coverage includes provider-recommended repairs and replacements needed because of body changes, irreparable damage, or repairs that cost more than replacement. Member cost sharing cannot exceed that for other covered benefits; repair and replacement protections have exceptions for misuse or theft. Extra devices for physical activities require medical-need findings by the treating physician or authorized advanced practice provider and the plan. A separate bathing device is covered when medically necessary because the original and primary extra device do not allow safe bathing. Individual plans covering these devices must count them as services and devices that help people regain or build skills under essential health benefit rules. Artificial eyes are excluded.

Better device access and disability protections

Starting January 1, 2027, plans covering prosthetic or orthotic care must provide access to at least two distinct in-state network providers. When a medically necessary covered device is unavailable in network, insurers must arrange an outside referral. They must pay the provider at a mutually agreed rate, less the member's cost share calculated at in-network levels. Insurers cannot deny benefits that help people regain or build skills solely because of an actual or perceived disability. They also cannot deny a device benefit for limb loss, absence, or impairment when they cover comparable medical or surgical care for the same activity in a nondisabled person. Prior approval rules must be nondiscriminatory and comparable to those for other benefits. Medical-need denials or limits must explain the reasons in writing and are open to appeal, with treating clinicians' input considered. Devices and services must come from accredited facilities and be prescribed by a licensed physician or authorized advanced practice provider. Plans must report claim counts and total payments for plan years 2027–2028 to the insurance commissioner; the legislative insurance committees' report is due July 1, 2029.

Prosthetic limit and upgrade protections removed

Starting January 1, 2027, the law removes permission for plans to set annual prosthetic limits of at least $50,000 per limb. It also removes the specific protection allowing members to choose a higher-priced device and pay the difference without provider penalties. The repeal sets no replacement annual limit and does not guarantee unlimited coverage.

Sponsors & Cosponsors

Sponsor

  • Troy Jude Hebert

    Republican • House

Cosponsors

  • Adrian Fisher

    Democratic • House

  • Annie Spell

    Republican • House

  • Barbara Reich Freiberg

    Republican • House

  • Candace N. Newell

    Democratic • House

  • Roy Daryl Adams

    Democratic • House

  • Delisha Boyd

    Democratic • House

  • Doyle Boudreaux

    Republican • House

  • Ed Larvadain III

    Democratic • House

  • Jacob Jules Landry

    Republican • House

  • Ken Brass

    Democratic • House

  • Michael Melerine

    Republican • House

  • Michael Robert Bayham Jr.

    Republican • House

  • Mike Johnson

    Republican • House

  • Pat Moore

    Democratic • House

  • Rodney Lyons

    Democratic • House

  • Steven Jackson

    Democratic • House

  • Tehmi Jahi Chassion

    Democratic • House

  • Vanessa Caston LaFleur

    Democratic • House

  • Vincent E. Cox III

    Republican • House

Roll Call Votes

All Roll Calls

Yes: 236 • No: 3

House vote • 5/29/2026

Read by title, roll called, yeas 94, nays 0, Senate amendments concurred in.

Yes: 94 • No: 0

Senate vote • 5/26/2026

Rules suspended. The amended bill was read by title, passed by a vote of 36 yeas and 0 nays, and ordered returned to the House. Motion to reconsider tabled.

Yes: 36 • No: 0

House vote • 4/15/2026

Read third time by title, amended, roll called on final passage, yeas 95, nays 3. Finally passed, title adopted, ordered to the Senate.

Yes: 95 • No: 3

House vote • 4/9/2026

Read by title, substitute title adopted, lies over in the same order of business, substitute for HB No. 477 reported by the Committee on Insurance

Yes: 11 • No: 0

Actions Timeline

  1. Signed by the Governor. Becomes Act No. 719.

    6/3/2026House

  2. Effective date: 06/03/2026.

    6/3/2026House

  3. Signed by the President of the Senate.

    6/1/2026Senate

  4. Sent to the Governor for executive approval.

    6/1/2026House

  5. Enrolled and signed by the Speaker of the House.

    5/31/2026House

  6. Read by title, roll called, yeas 94, nays 0, Senate amendments concurred in.

    5/29/2026House

  7. Scheduled for concurrence on 05/29/2026.

    5/27/2026House

  8. Rules suspended. The amended bill was read by title, passed by a vote of 36 yeas and 0 nays, and ordered returned to the House. Motion to reconsider tabled.

    5/26/2026Senate

  9. Received from the Senate with amendments.

    5/26/2026House

  10. Reported without Legislative Bureau amendments. Read by title and passed to third reading and final passage.

    5/21/2026Senate

  11. Rules suspended. Recalled from Committee.

    5/20/2026Senate

  12. Read by title and referred to the Legislative Bureau.

    5/20/2026Senate

  13. Senate Committee amendments read and adopted.

    4/29/2026Senate

  14. Read by title. Recommitted to the Committee on Finance.

    4/29/2026Senate

  15. Reported with amendments.

    4/28/2026Senate

  16. Read second time by title and referred to the Committee on Insurance.

    4/21/2026Senate

  17. Received in the Senate. Read first time by title and placed on the Calendar for a second reading.

    4/20/2026Senate

  18. Read third time by title, amended, roll called on final passage, yeas 95, nays 3. Finally passed, title adopted, ordered to the Senate.

    4/15/2026House

  19. Scheduled for floor debate on 04/15/2026.

    4/14/2026House

  20. Read by title, ordered engrossed, passed to 3rd reading.

    4/13/2026House

  21. Read by title, substitute title adopted, lies over in the same order of business, substitute for HB No. 477 reported by the Committee on Insurance (11-0).

    4/9/2026House

Bill Text

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