Virginia · 2026 Regular Session · Bill
HB 216: Health insurance; coverage for prosthetic and custom orthotic devices and components, reports.
In committee Official data
- Introduced
- In committee
- Passed one chamber
- Passed both chambers
- Enacted
Last official action: ·Record last updated:
Plain-language summary
HB 216 is a bill introduced in the Virginia House on January 7, 2026. According to its official title, it concerns: Health insurance; coverage for prosthetic and custom orthotic devices and components, reports. Primary sponsor: Dan Helmer (Democratic). It lists 4 additional sponsors. Most recent recorded action (February 18, 2026): Left in Labor and Commerce.
Generated automatically from the official title, sponsor list, and status record only. It does not characterize the bill’s purpose or effects. How summaries are written
Official summary
Abstract published by the legislature (via Open States). Text as published by the legislature; reproduced verbatim.
Health insurance; State Plan for Medical Assistance; coverage for prosthetic and custom orthotic devices and components; reports. Amends provisions related to health insurance coverage for prosthetic devices and components to include custom orthotic devices and components. Under the bill, such coverage does not include repair and replacement due to theft or loss and may include more than one prosthetic or custom orthotic device when medically necessary, as determined by an enrollee's provider. The bill prohibits an insurer from denying coverage for a prosthetic or custom orthotic device for an individual with limb loss, limb absence, or limb impairment that would otherwise be covered for a nondisabled individual seeking medical or surgical intervention. The bill requires health plans that provide such coverage to include language describing an enrollee's rights related to coverage for prosthetic and custom orthotic devices and provide a written explanation of any claim denials. The bill also directs the Department of Medical Assistance Services to seek the necessary permissions from the Centers for Medicare and Medicaid Services to provide payment of medical assistance for prosthetic and custom orthotic devices, subject to the same requirements as insurers. Such payment is conditional on the Department obtaining all necessary approvals and federal financial participation. The bill sunsets on July 1, 2027, if such approval and federal financial participation is not obtained. The bill directs the health insurance carriers, the Department of Medical Assistance Services, and any managed care plan administering Medicaid benefits in the Commonwealth to submit reports to the Health Insurance Reform Commission regarding implementation of the provisions of the bill during plan years 2027 and 2028.
Sponsors
Sponsors by party (alphabetical): Democratic 3
| Name | Role | Party | Chamber | District |
|---|---|---|---|---|
| Dan Helmer | Primary sponsor | Democratic | House | 10 |
| Mark C. Downey | Co-sponsor | Not applicable (committee) | — | — |
| John Chilton McAuliff | Co-sponsor | Not applicable (committee) | — | — |
| Rip Sullivan | Co-sponsor | Democratic | House | 6 |
| Rod Willett | Co-sponsor | Democratic | House | 58 |
“Support” is shown only as formal sponsorship recorded by the legislature. Roll-call votes are available on the official bill page.
Recent official actions
- Left in Labor and Commerce
- Subcommittee recommends laying on the table (9-Y 0-N)
- Assigned HCL sub: Subcommittee #1
- Referred to Committee on Labor and Commerce
- Prefiled and ordered printed; Offered 01-14-2026 26104550D