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H 4549

An Act to improve outcomes for persons with limb loss and limb difference

194th Legislature (2025-2026) Introduced by Michelle Badger and 4 co-sponsors

Bill H 4549 mandates Massachusetts insurance coverage for prosthetics, orthotics, and rehabilitation services for people with limb loss and limb difference to improve accessibility and outcomes.

Reported favorably by committee and referred to the committee on Health Care Financing
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WeVote Research Nonpartisan
Bill Summary · H 4549

Legislative bill overview

H 4549 establishes comprehensive support services and insurance coverage requirements for individuals with limb loss and limb difference in Massachusetts. The bill aims to improve access to prosthetics, orthotics, rehabilitation services, and related care through enhanced insurance mandates and state-level coordination.

Why is this important

Limb loss and congenital limb differences significantly impact quality of life, employment, and independence, yet prosthetic devices and specialized care are often expensive and inconsistently covered. This legislation addresses gaps in insurance coverage and accessibility that leave many residents without adequate resources for mobility devices and rehabilitation services.

Potential points of contention

  • Insurance mandate costs: Requiring insurers to cover prosthetics and orthotics without limits may increase premiums and out-of-pocket costs for all enrollees; insurers may argue coverage restrictions are necessary for fiscal sustainability
  • Definition scope: Determining what qualifies as medically necessary prosthetics/orthotics could create disputes between patients, providers, and insurers over coverage eligibility
  • Implementation timeline: Mandating rapid service expansion may strain rehabilitation providers and prosthetic manufacturers, potentially delaying care during transition period
  • Public program burden: If the bill extends requirements to MassHealth, state budget impacts could be substantial given the program's fiscal constraints

Compiled from official sources — confirm details with the bill’s official record.

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