HB426

HB426 requires Medicaid to cover the full cost of a qualifying cranial-remolding orthosis for a child enrolled in the program, with CHIP providing coverage in the same manner. The device is a custom-fitted or custom-made medical device worn on the head to correct a deformity, improve function or relieve symptoms of structural cranial disease—often described as a remolding helmet. Coverage cannot be less favorable than Medicaid coverage for other orthotics. This is a Medicaid and CHIP requirement, not a mandate on every private insurance plan. Final law

The law identifies two diagnostic routes. A child may qualify with craniosynostosis. For plagiocephaly or brachycephaly, the child must be 3–18 months old, have documented failure to respond to conservative therapy for at least two months, and meet a specified measurement test: either an asymmetry with a right/left craniofacial measurement difference greater than six millimeters, or the specified head-length/head-width disproportion with a cephalic index two standard deviations above or below the mean. The age, therapy and measurement conditions are attached to the second route, not stated as conditions on the separate craniosynostosis route. A diagnosis and clinical assessment matter; this is not coverage for every helmet or head-shape concern. Clinical eligibility in section 32.03126

The governor signed HB426 June 20, 2025, and it took effect September 1, 2025. If a state agency determines that federal approval or a waiver is needed for a provision, it must request that approval and may delay implementing the provision until approval is granted. The effective date alone therefore does not prove that a particular claim was payable that day. Federal-approval condition and timing · Official history