How SB 83 changes current law

AI-generated reading aid from the bill's amendatory text — verify against the official bill.

The bill mandates coverage, prior authorization, and establishes a minimum reimbursement rate for breast reconstruction surgeries in Arkansas.

• 23-79-2902

  On and after January 1, 2026, a health benefit plan that is offered, issued, or renewed in this state shall provide coverage for all modalities, types, and techniques of a healthcare service provided for a breast reconstruction surgery and shall cover any surgery determined as the best course of treatment by a healthcare professional, consistent with prevailing medical standards, and in consultation with the patient.

  Health benefit plans must cover all aspects of breast reconstruction surgery.

• 23-79-2902

  The coverage for breast reconstruction surgery under this section: (1) Shall be subject to policy deductibles, copayment requirements, or coinsurance requirements of a healthcare insurer at a cost that is no more than those costs associated with the health benefit plan's in-network rate for the healthcare service; (2) Does not diminish or limit benefits otherwise allowable under a health benefit plan; (3) Shall not affect an enrollee's eligibility or continued eligibility to enroll or renew coverage under the terms of the health benefit plan solely for the purpose of avoiding the requirements of this subchapter.

  Establishes specifics about coverage costs, limits, and maintains enrollee eligibility.

• 23-79-2903

  A healthcare insurer shall require prior authorization for breast reconstruction surgery.

  Mandates that insurers obtain prior authorization for breast reconstruction surgeries.

• 23-79-2903

  If a healthcare insurer does not have a participating provider who provides a breast reconstruction surgery that has been determined as the best course of treatment by a healthcare professional and is consistent with prevailing medical standards and in consultation with the patient, then the healthcare insurer that provides a prior authorization or predetermination of the healthcare service shall automatically approve a single case agreement at the same rate as specified under § 23-79-2904(a).

  Requires automatic approval for cases where network providers are unavailable.

• 23-79-2904

  If a healthcare insurer does not have a participating provider who provides a breast reconstruction surgery that has been determined as the best course of treatment by a healthcare professional and is consistent with prevailing medical standards and in consultation with the patient, then the healthcare insurer that provides a prior authorization or predetermination of the healthcare service shall automatically approve a single case agreement at the same rate as specified under § 23-79-2904(a).

  Ensures patients can receive necessary surgeries even when in-network options are lacking.