| 3 | 2 | | *ANS347* 03/19/2025 10:32:07 AM ANS347 |
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| 4 | 3 | | State of Arkansas 1 |
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| 5 | 4 | | 95th General Assembly A Bill 2 |
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| 6 | 5 | | Regular Session, 2025 HOUSE BILL 1859 3 |
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| 7 | 6 | | 4 |
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| 8 | 7 | | By: Representatives Rose, Achor, D. Garner, Hudson 5 |
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| 9 | 8 | | By: Senators J. Bryant, G. Leding 6 |
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| 10 | 9 | | 7 |
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| 11 | 10 | | For An Act To Be Entitled 8 |
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| 12 | 11 | | AN ACT TO AMEND THE LAW CONCERNING MASTECTOMIES; AND 9 |
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| 13 | 12 | | FOR OTHER PURPOSES. 10 |
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| 14 | 13 | | 11 |
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| 15 | 14 | | 12 |
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| 16 | 15 | | Subtitle 13 |
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| 17 | 16 | | TO AMEND THE LAW CONCERNING 14 |
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| 18 | 17 | | MASTECTOMIES. 15 |
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| 19 | 18 | | 16 |
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| 20 | 19 | | BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 17 |
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| 21 | 20 | | 18 |
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| 22 | 21 | | SECTION 1. Arkansas Code § 23 -99-405 is amended to read as follows: 19 |
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| 23 | 22 | | 23-99-405. Mastectomies. 20 |
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| 24 | 23 | | (a) Every health benefit plan providing mastectomy benefits and issued 21 |
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| 25 | 24 | | or renewed after July 16, 2003, shall conform with the requirements of the 22 |
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| 26 | 25 | | Women's Health and Cancer Rights Act of 1998, 42 U.S.C. §§ 300gg -6 and 300gg-23 |
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| 27 | 26 | | 52, as it existed on January 1, 2003 January 1, 2025. 24 |
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| 28 | 27 | | (b) To the extent the requirements of this section do not conflict 25 |
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| 29 | 28 | | with federal law, rules, or regulations, each healthcare insurer providing 26 |
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| 30 | 29 | | mastectomy benefits in a health benefit plan shall provide, in a manner 27 |
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| 31 | 30 | | determined in consultation with the attending physician and the enrollee or 28 |
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| 32 | 31 | | insured: 29 |
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| 33 | 32 | | (1) For medical and surgical benefits for any hospital stay in 30 |
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| 34 | 33 | | connection with a mastectomy for not less than forty -eight (48) hours unless 31 |
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| 35 | 34 | | the decision to discharge the patient before the expiration of the minimum 32 |
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| 36 | 35 | | length of stay is made by an attending physician in consultation with the 33 |
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| 37 | 36 | | enrollee or insured; 34 |
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| 38 | 37 | | (2) The following medical and surgical benefits with respect to 35 |
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| 39 | 38 | | mastectomy coverage if an enrollee or insured receives benefits in connection 36 HB1859 |
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| 40 | 39 | | |
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| 41 | 40 | | 2 03/19/2025 10:32:07 AM ANS347 |
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| 42 | 41 | | with a mastectomy and elects breast reconstruction: 1 |
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| 43 | 42 | | (A) Surgery and reconstruction of the breast on which the 2 |
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| 44 | 43 | | mastectomy has been performed; 3 |
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| 45 | 44 | | (B) Surgery and reconstruction of the other breast to 4 |
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| 46 | 45 | | produce a symmetrical appearance; and 5 |
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| 47 | 46 | | (C) Prostheses and coverage for physical complications at 6 |
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| 48 | 47 | | all stages of a mastectomy, including lymphedemas; and 7 |
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| 49 | 48 | | (3) Written notice of the availability of coverage under this 8 |
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| 50 | 49 | | section to the enrollee or insured upon enrollment and annually thereafter ; 9 |
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| 51 | 50 | | and 10 |
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| 52 | 51 | | (4)(A) Medical and surgical benefits for: 11 |
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| 53 | 52 | | (i) Artificial or biological mesh used to support 12 |
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| 54 | 53 | | tissue; and 13 |
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| 55 | 54 | | (ii) A nerve graft to preserve or restore nerve 14 |
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| 56 | 55 | | function. 15 |
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| 57 | 56 | | (B) A healthcare insurer, health benefit plan, or group 16 |
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| 58 | 57 | | health plan shall reimburse a healthcare provider for the supplies required 17 |
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| 59 | 58 | | for the healthcare services provided under subdivision (b)(4)(A) of this 18 |
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| 60 | 59 | | section at a rate equal to or greater than one hundred percent (100%) of the 19 |
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| 61 | 60 | | healthcare provider's acquisition cost . 20 |
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| 62 | 61 | | (c) No healthcare A healthcare insurer providing mastectomy benefits 21 |
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| 63 | 62 | | under this section shall not: 22 |
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| 64 | 63 | | (1) Deny an enrollee or insured eligibility or continued 23 |
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| 65 | 64 | | eligibility to enroll or renew coverage under the terms of the health benefit 24 |
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| 66 | 65 | | plan solely for the purpose of avoiding the requirements of this section; or 25 |
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| 67 | 66 | | (2) Penalize, reduce, or limit the reimbursement of an attending 26 |
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| 68 | 67 | | provider or induce the provider to provide care in a manner inconsistent with 27 |
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| 69 | 68 | | this section. 28 |
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| 70 | 69 | | (d) A healthcare insurer or health benefit plan shall cover the 29 |
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| 71 | 70 | | healthcare services under this section if the service is performed at a 30 |
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| 72 | 71 | | licensed facility, including without limitation: 31 |
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| 73 | 72 | | (1) A hospital; 32 |
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| 74 | 73 | | (2) A hospital outpatient department; and 33 |
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| 75 | 74 | | (3) An ambulatory surgery center. 34 |
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| 76 | 75 | | (e) This section does not apply to a plan providing health benefits to 35 |
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| 77 | 76 | | state and public school employees under § 21 -5-401 et seq. 36 HB1859 |
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| 78 | 77 | | |
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| 80 | 79 | | (f) This section expires on June 30, 2031, unless extended by the 1 |
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| 81 | 80 | | General Assembly. 2 |
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| 82 | 81 | | 3 |
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| 83 | 82 | | 4 |
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