New York legislation · 2025-2026 General Assembly
New York A11406: Requires certain health insurance coverage for prostheses and custom orthoses
Status: In committee, June 3, 2026
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.
What the bill says
An act to amend the insurance law, the social services law and the public health law, in relation to requiring certain health insurance coverage for prostheses and custom orthoses.
From the amended text, June 3, 2026:
AN ACT to amend the insurance law, the social services law and the public health law, in relation to requiring certain health insurance coverage for prostheses and custom orthoses THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 42 to read as follows: (42) (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL, MEDICAL OR SURGICAL EXPENSES SHALL INCLUDE 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. (B) COVERAGE PROVIDED UNDER THIS PARAGRAPH SHALL INCLUDE: (I) A PROSTHETIC OR ORTHOTIC DEVICE DETERMINED BY THE ENROLLEE'S HEALTH CARE PROVIDER TO BE THE MOST APPROPRIATE MODEL THAT ADEQUATELY MEETS THE MEDICAL NEEDS OF SUCH ENROLLEE; (II) A PROSTHETIC OR CUSTOM ORTHOTIC DEVICE DETERMINED BY THE ENROLLEE'S HEALTH CARE PROVIDER TO BE THE MOST APPROPRIATE MODEL THAT MEETS THE MEDICAL NEEDS OF SUCH ENROLLEE FOR PURPOSES OF PERFORMING PHYSICAL ACTIVITIES, INCLUDING, BUT NOT LIMITED TO, RUNNING, BIKING, SWIMMING, STRENGTH TRAINING, AND TO MAXIMIZE SUCH ENROLLEE'S WHOLE-BODY HEALTH AND LOWER AND/OR UPPER LIMB FUNCTION; (III) A …
Sponsors
- Philip Ramos (D, 6) · primary sponsor
Latest actions
- : PRINT NUMBER 11406A
- : AMEND AND RECOMMIT TO INSURANCE
- : REFERRED TO INSURANCE
Subjects: Insurance Law
Common questions
- What is A11406?
- A11406 is a bill in the New York Legislature (2025-2026 General Assembly): Requires certain health insurance coverage for prostheses and custom orthoses.
- What does A11406 do?
- In its own words: An act to amend the insurance law, the social services law and the public health law, in relation to requiring certain health insurance coverage for prostheses and custom orthoses.
- What is the status of A11406?
- In committee as of June 3, 2026. Latest action: PRINT NUMBER 11406A (June 3, 2026).
- Who sponsored A11406?
- Philip Ramos (D, 6).
- Where is the official record for A11406?
- On the New York Legislature website: https://www.nysenate.gov/legislation/bills/2025/A11406
Source: official New York record. Tracked by Delilah, AI for legislation across all 50 states and Congress.