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A 11406 New York Assembly · 2025 Regular Session

Requires certain health insurance coverage for prostheses and custom orthoses

Summary
Requires health insurance coverage for prosthetic and orthotic devices at a rate no less than the current quarter's Medicare durable medical equipment, prosthetics, orthotics and supplies fee schedule established by the Centers for Medicare and Medicaid services for prosthetic and orthotic devices and services.
Issues: ✓ HealthcareSupports HealthcareBill mandates insurance coverage for prosthetic and orthotic devices, expanding access to essential medical equipment and strengthening healthcare benefits.90% confidence ✓ VeteransSupports VeteransBill mandates health insurance coverage for prosthetic and orthotic devices, directly improving healthcare access and benefits for veterans who require such devices.85% confidence
Bill status in committee 1 of 4 stages cleared
Introduction
May 2026
Committee Review
Floor Vote
Governor
Introduced May 15, 2026 Last action Jun 3, 2026
Maddy AI version diff · 1 comparison

What changed between versions

A11406 → A11406A · 5 edits
MODERATE
The bill was amended to streamline coverage requirements for prosthetic and orthotic devices by removing outdated federal citation references and consolidating the payment standard into a single clause. Additionally, the amendment added new mandatory coverage items, including all necessary materials, user instruction, and medically necessary repairs or replacements for specific devices. These changes ensure that insurance policies provide comprehensive, equitable coverage that aligns with current Medicare standards and addresses the full lifecycle of medical devices.
DEFINITION

Removed specific citations to federal laws and regulations (42 U.S.C. and 42 C.F.R.) that were used to define coverage standards.

REQUIREMENT

Modified the payment requirement to be a single clause mandating payment at a rate no less than the current quarter's Medicare fee schedule for prosthetic and orthotic devices.

Added a new requirement for coverage to include all materials and components necessary for the use of the prostheses and orthoses.

Added a new requirement for coverage to include instruction to the enrollee on how to use the device.

Added a new requirement for coverage to include the medically necessary repair or replacement of prosthetic or orthotic devices.

Floor votes

How they voted

No floor votes recorded yet.
Full legislative history

Actions timeline

Total actions
3
Key actions
2
Committee
1
Amendments
2
Jun 3, 2026
Lower · Passed
PRINT NUMBER 11406A
lower
Jun 3, 2026
Lower · Passed
AMEND AND RECOMMIT TO INSURANCE
lower
May 15, 2026
Committee
REFERRED TO INSURANCE
lower
0 primary · 0 co-sponsors

Sponsors

No sponsor information available.