In April, Gov. Huckabee Sanders signed numerous healthcare bills into law.
Act 424 (previously SB 83) mandates coverage for breast reconstruction surgery and requires prior authorization for breast reconstruction surgeries. The act requires health benefit plans to cover all services provided for breast reconstruction surgeries and to cover any surgery determined to be the best course of treatment by a healthcare professional consistent with prevailing medical standards.
Additionally, if a covered individual is forced to use an out-of-network provider due to a healthcare insurer's network inadequacy, the individual's financial responsibility shall remain at an in-network rate. The act also establishes reimbursement rules for compensating out-of-network providers.
These requirements apply to health benefit plans offered, issued, or renewed in the state on or after January 1, 2026.
Act 553 (previously SB 123) amends the law concerning coverage for mammograms and breast ultrasounds and adds a new definition of “supplemental breast examinations.” As amended, a healthcare insurer must ensure that health benefit plans that provide coverage for diagnostic breast examinations, examinations for breast cancer, and supplemental breast examinations do not impose any cost-sharing requirements on individuals.
Act 627 (previously HB 1333) requires health benefit plans to provide coverage for breastfeeding and lactation consultant services in an outpatient setting. Such coverage is not subject to an annual deductible, copayment, or coinsurance limit established for other covered plan benefits. The act applies to health benefit plans offered, issued, renewed, delivered, or extended in the state on and after January 1, 2026.
Act 628 (previously HB 1424) requires health benefit plans to cover medically necessary expenses for the treatment of diseases and conditions caused by severe obesity, including bariatric surgery, revision bariatric surgery, pre-operative care, and post-operative care. It does not require a healthcare insurer to provide coverage for injectable drugs used to lower glucose levels or any other drugs prescribed for weight loss. These requirements apply to health benefit plans that are offered, issued, renewed, delivered, or extended in the state on and after January 1, 2026.
Act 859 (previously HB 1142), also known as the Reproductive Empowerment and Support Through Optimal Restoration Act (RESTORE Act), requires a healthcare insurer doing business in the state to cover restorative reproductive medicine. Restorative reproductive medicine is a scientific approach to reproductive medicine and fertility that seeks to cooperate with or restore the normal physiology and anatomy of the human reproductive system without the use of methods that are inherently suppressive, circumventive, or destructive to natural human functions.
Act 860 (previously HB 1079) requires health benefit plans to provide coverage for genetic testing for an inherited gene mutation for an individual with a personal or family history of cancer if the genetic testing provides clinical utility, is ordered or recommended by a healthcare provider, and is supported by medical and scientific evidence. The act also mandates coverage for evidence-based cancer imaging for certain individuals. The requirements apply to health benefit plans offered, issued, or renewed in the state on and after January 1, 2026.
Act 866 (previously HB 1826) requires health benefit plans to provide coverage for delivery of a newborn in a licensed birthing center. Specifically, on and after January 1, 2026, health benefit plans that are offered, issued, renewed, delivered, or extended in the state shall provide the same coverage to an enrollee for birthing services received in a licensed birthing center as provided for birthing services received in a hospital. Furthermore, the coverage for licensed birthing centers is not subject to a greater deductible, coinsurance, copayment, or out-of-pocket limit than any other benefit provided by health benefit plans.
In Arkansas, acts without a specified effective date or emergency clause generally take effect on the 91st day following the adjournment of the state legislative session. For 2025, the date of adjournment was May 5, 2025, so acts lacking a specified effective date or emergency clause will generally become effective on Tuesday, August 5, 2025.
Employers that sponsor fully insured plans should be aware of these new coverage mandates and should contact their carriers for further information regarding the requirements and to confirm the effective dates.