H 4549
An Act to improve outcomes for persons with limb loss and limb difference
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- Passed House
- Passed Senate
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Bill overview
This bill aims to improve healthcare outcomes for individuals with limb loss or limb difference in Massachusetts. It clarifies definitions related to orthotics and prosthetics, expands coverage for specialized prosthetic devices used for physical activities, and ensures nondiscriminatory coverage decisions. The bill also addresses coverage requirements for MassHealth members and establishes standards for provider networks to ensure access to necessary care and devices.
Key provisions
- Defines ‘orthosis’ and ‘prosthetic device’ for clarity.
- Expands coverage for prosthetic and orthotic devices designed for specific physical activities, including those for showering and bathing.
- Requires insurers to provide nondiscriminatory coverage for habilitative and rehabilitative benefits, including prosthetics and orthotics.
- Ensures access to medically necessary clinical care and prosthetic/orthotic devices from at least two providers in the managed care network.
- Provides for out-of-network reimbursement at a mutually agreed-upon rate.
- Allows for replacement of prosthetic or orthotic devices without regard to continuous use or useful lifetime, based on a healthcare provider’s determination of necessity.
- Establishes prescription requirements for MassHealth members seeking orthotic or prosthetic coverage.
- Extends coverage for prosthetic and orthotic devices to MassHealth members under similar terms as other durable medical equipment.
Who is affected
Sponsors
Official sponsors from legislative records.
Primary sponsor
Joint Committee on Financial Services
Cosponsors
Daniel Cahill
Jacob R. Oliveira
Joanne M. Comerford
Arguments in favor
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Bill H.4549 194th (Current)
An Act to improve outcomes for persons with limb loss and limb difference
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Bill Information
Bill Information
Sponsor: Joint Committee on Financial Services Status: Referred to House Committee on Ways and Means
Tabs
Bill History Cosponsors Committee Vote Fiscal Note Committee Summary
Bill History
Displaying 4 actions for Bill H.4549
| Date | Branch | Action |
| 9/29/2025 | House | Reported from the committee on Financial Services |
| 9/29/2025 | House | New draft of H1178 |
| 9/29/2025 | House | Reported favorably by committee and referred to the committee on Health Care Financing |
| 12/4/2025 | House | Committee recommended bill ought to pass and referred to the committee on House Ways and Means |
Similar Bills
H.1178 194th (Current)
An Act to improve outcomes for persons with limb loss and limb difference
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An Act to improve outcomes for persons with limb loss and limb difference
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