Reimbursement For Certain Medical Equipment, Devices, and Supplies

Sec. 1652.059. REIMBURSEMENT FOR CERTAIN MEDICAL EQUIPMENT, DEVICES, AND SUPPLIES. (a) In this section, terms defined by Section 566.001 have the meanings assigned by that section. (b) A Medicare supplement benefit plan issuer is not required to reimburse an enrollee or nonparticipating supplier for the amount by which a charge for durable medical equipment, orthotic devices or supplies, or prosthetic devices or supplies exceeds 115 percent of the Medicare-allowed amount for the equipment, device, or supply. (c) This section does not prohibit a Medicare supplement benefit plan issuer and a nonparticipating supplier from negotiating a level and type of reimbursement for durable medical equipment or orthotic or prosthetic devices or supplies. Added by Acts 2025, 89th Leg., R.S., Ch. 1003 (S.B. 1330), Sec. 2, eff. September 1, 2025.