Florida HB 1301: Child Welfare

Bill Text

HB 1301 2026

CODING: Words stricken are deletions; words underlined are additions.
hb1301-00
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S

A bill to be entitled 1
An act relating to coverage for orthotics and 2
prosthetics services; amending s. 409.906, F.S.; 3
authorizing the Agency for Health Care Administration 4
to authorize and pay for specified orthotics and 5
prosthetics services for Medicaid recipients; 6
requiring the agency to seek federal approval and 7
amend contracts as necessary to implement the act; 8
creating ss. 627.64085, 627.6614, and 641.31079, F.S.; 9
requiring individual health insurance policies; group, 10
blanket, and franchise health insurance policies; and 11
health maintenance contracts, respectively, to provide 12
coverage for specified orthotics and prosthetics 13
services; prohibiting health insurers and health 14
maintenance organizations from denying claims under 15
certain circumstances; requiring health insurers and 16
health maintenance organizations to submit annual 17
reports of specified information to the Office of 18
Insurance Regulation; providing an effective date. 19
20
Be It Enacted by the Legislature of the State of Florida: 21
22
Section 1. Subsection (10) of section 409.906, Florida 23
Statutes, is amended to read: 24
409.906 Optional Medicaid services.—Subject to specific 25

HB 1301 2026

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appropriations, the agency may make payments for services which 26
are optional to the state under Title XIX of the Social Security 27
Act and are furnished by Medicaid providers to recipients who 28
are determined to be eligible on the dates on which the services 29
were provided. Any optional service that is provided shall be 30
provided only when medically necessary and in accordance with 31
state and federal law. Optional services rendered by providers 32
in mobile units to Medicaid recipients may be restricted or 33
prohibited by the agency. Nothing in this section shall be 34
construed to prevent or limit the agency from adjusting fees, 35
reimbursement rates, lengths of stay, number of visits, or 36
number of services, or making any other adjustments necessary to 37
comply with the availability of moneys and any limitations or 38
directions provided for in the General Appropriations Act or 39
chapter 216. If necessary to safeguard the state's systems of 40
providing services to elderly and disabled persons and subject 41
to the notice and review provisions of s. 216.177, the Governor 42
may direct the Agency for Health Care Administration to amend 43
the Medicaid state plan to delete the optional Medicaid service 44
known as "Intermediate Care Facilities for the Developmentally 45
Disabled." Optional services may include: 46
(10) DURABLE MEDICAL EQUIPMENT.— 47
(a) The agency may authorize and pay for certain durable 48
medical equipment and supplies provided to a Medicaid recipient 49
as medically necessary. 50

HB 1301 2026

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(b) The agency may authorize and pay for all of the 51
following orthotics and prosthetics services: 52
1. Orthoses and prostheses as those terms are defined in 53
s. 468.80. Coverage must include payment for the model of an 54
orthosis or a prosthesis which is deemed by the recipient's 55
provider to be the most appropriate to meet the medical needs of 56
the recipient to perform activities of daily living, essential 57
job-related activities, and physical recreational activities, 58
such as running, biking, swimming, strength training, and other 59
activities that maximize the recipient's full body health and 60
lower and upper limb function. 61
2. All materials and components necessary to use the 62
orthosis or prosthesis. 63
3. Instruction on the use of the orthosis or prosthesis. 64
4. Any necessary repairs or replacement of the orthosis or 65
prosthesis. 66
Section 2. The Agency for Health Care Administration shall 67
seek federal approval and amend contracts as necessary to 68
implement the changes made to s. 409.906, Florida Statutes, by 69
this act. 70
Section 3. Section 627.64085, Florida Statutes, is created 71
to read: 72
627.64085 Orthotics and prosthetics services.— 73
(1) A health insurance policy issued, amended, delivered, 74
or renewed in this state on or after July 1, 2026, must provide 75

HB 1301 2026

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coverage for all of the following: 76
(a) Orthoses and prostheses as those terms are defined in 77
s. 468.80 if the insured's provider determines that an orthosis 78
or a prosthesis is medically necessary for the insured to 79
perform activities of daily liv