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Bill

Bill

HB 1859

TO AMEND THE LAW CONCERNING MASTECTOMIES.

2025 Regular Session Introduced by Brandon Achor and 5 co-sponsors

Act 561 enhances mastectomy coverage in Arkansas, ensuring 48-hour hospital stays, reconstruction benefits, and treatment for complications, improving patient care.

Notification that HB1859 is now Act 561
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Bill Summary · HB 1859

Summary of House Bill 1859 (Act 561)

Purpose and Intent

House Bill 1859, now known as Act 561, aims to amend existing laws concerning mastectomies in the state of Arkansas. The primary intent of this legislation is to enhance the coverage and benefits provided by health insurance plans for individuals undergoing mastectomies, ensuring compliance with updated federal standards and improving patient care.

Key Provisions

The bill introduces several important changes to the Arkansas Code § 23-99-405 regarding mastectomy benefits:

  1. Alignment with Federal Law:

    • The bill updates the reference to the Women's Health and Cancer Rights Act of 1998, changing the compliance date from January 1, 2003, to January 1, 2025.

  2. Minimum Hospital Stay:

    • Health benefit plans must provide coverage for a minimum hospital stay of 48 hours following a mastectomy, unless an earlier discharge is agreed upon by the attending physician and the patient.

  3. Breast Reconstruction Benefits:

    • Coverage must include:
      • Surgery and reconstruction of the breast that underwent mastectomy.
      • Procedures to achieve a symmetrical appearance.
      • Surgery and reconstruction of the opposite breast if desired.

  4. Complications Coverage:

    • Health plans are required to cover prostheses and treatment for physical complications arising from mastectomies, including lymphedema.

  5. Additional Medical Benefits:

    • Coverage for:
      • Artificial or biological mesh to support function.
      • Nerve grafts to preserve or restore nerve tissue.
    • Insurers must reimburse healthcare providers for these services at a rate equal to or greater than 100% of the provider's acquisition cost.

  6. Non-Discrimination Clause:

    • Insurers cannot deny coverage or penalize providers to avoid compliance with the new requirements.

  7. Facility Coverage:

    • Services must be covered if performed at licensed facilities, including hospitals, outpatient departments, and ambulatory surgery centers.

  8. Exemption:

    • The provisions do not apply to health benefit plans for state and public school employees.

  9. Expiration Clause:

    • The section is set to expire on June 30, 2031, unless extended by the General Assembly.

Affected Parties

  • Patients: Individuals undergoing mastectomies will benefit from improved coverage and support for reconstruction and complications.
  • Healthcare Providers: Medical professionals will have clearer guidelines for reimbursement and patient care.
  • Insurance Companies: Health insurers will need to adjust their policies to comply with the new requirements.

Legislative Timeline

  • Introduced: March 19, 2025
  • Passed: April 9, 2025
  • Notification of Act: April 14, 2025

This bill represents a significant step toward improving healthcare access and quality for individuals affected by breast cancer and related conditions in Arkansas.

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

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