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Bill

A 6586

Requires health insurance policies and Medicaid to cover patient navigation services

2025 Regular Session Introduced by Karl Brabenec and 18 co-sponsors

Summary of Bill A 6586: Requires Health Insurance Coverage for Patient Navigation Services Purpose and IntentThe main purpose of Bill A 6586 is to require health insurance policies

REFERRED TO INSURANCE
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Bill Summary · A 6586

Summary of Bill A 6586: Requires Health Insurance Coverage for Patient Navigation Services

Purpose and Intent

The main purpose of Bill A 6586 is to require health insurance policies, including Medicaid, to cover patient navigation services. Patient navigation services are designed to help patients, especially those from underserved communities, overcome barriers to accessing and receiving quality healthcare.

Key Provisions

  • Mandates that all health insurance policies issued in the state, including Medicaid, provide coverage for patient navigation services.
  • Defines "patient navigation services" as assistance provided by trained navigators to help patients:
    • Identify and access appropriate healthcare services
    • Understand health insurance benefits and coverage
    • Obtain necessary documentation
    • Coordinate care between multiple providers
    • Access community resources and support services
  • Requires insurance plans to reimburse patient navigation service providers at reasonable rates.
  • Directs the state health department to establish training and certification requirements for patient navigators.

Affected Stakeholders

  • Health insurance policyholders, including Medicaid recipients, who would gain access to patient navigation services through their coverage.
  • Healthcare providers, including hospitals, clinics, and community health organizations, that employ or contract with patient navigators.
  • Patient navigator training and certification programs that would need to meet state standards.

Procedural and Timeline Details

  • The bill was introduced in the state legislature on March 6, 2025 and has been referred to the Insurance Committee for consideration.
  • If enacted, the patient navigation coverage requirement would take effect for all new and renewed insurance policies starting January 1, 2026.
  • The state health department would have 6 months from the bill's effective date to establish the patient navigator training and certification program.

Overall, Bill A 6586 aims to improve healthcare access and outcomes, especially for underserved populations, by ensuring health plans cover the costs of professional patient navigation services.

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

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