TO AMEND THE LAW CONCERNING MASTECTOMIES.

More coverage for Arkansas mastectomy patients

Arkansas health plans offering mastectomy benefits and issued or renewed after July 16, 2003, must follow federal coverage standards. These are the Women's Health and Cancer Rights Act standards as they stood on January 1, 2025. The following requirements apply where they do not conflict with federal law. Hospital care connected to a mastectomy must include at least a 48-hour stay. Earlier discharge is allowed when the attending doctor, consulting with the patient, finds it appropriate. For patients choosing breast reconstruction, coverage includes rebuilding the affected breast and surgery on the other breast for symmetry. Plans must also cover breast prostheses and physical complications at all stages, including lymphedema, or swelling from fluid buildup. Coverage includes artificial or biological mesh to support tissue and nerve grafts to preserve or restore nerve function. Insurers must pay providers at least 100% of their purchase cost for supplies needed for mesh and nerve-graft services. Coverage applies at licensed facilities, including hospitals, hospital outpatient departments, and ambulatory surgery centers. Insurers must give written coverage notices at enrollment and every year afterward. They cannot deny eligibility or continued enrollment solely to avoid these requirements. They also cannot penalize providers, reduce payments, or offer incentives for care that violates these rules. These requirements exclude the health benefits plan for Arkansas state and public school employees. They expire June 30, 2031, unless the General Assembly extends them.