HB1052
To Mandate Coverage For Certain Respiratory Syncytial Virus Disease Immunization Technologies For Certain Individuals.
AI-Generated Summary
This bill proposes to add a new subchapter to Arkansas Code Title 23, Chapter 79, concerning coverage for certain immunization technologies. Specifically, it mandates that health benefit plans offered in Arkansas must provide coverage for monoclonal antibodies used for the immunization of infants against respiratory syncytial virus disease. This coverage must align with guidelines issued by the United States Food and Drug Administration. The mandated coverage will not be subject to annual deductibles, copayments, or coinsurance limits that are established for other benefits within a health benefit plan. Furthermore, this coverage is not intended to diminish or limit any other benefits already provided under a health benefit plan. The bill defines "health benefit plan" broadly to include various types of insurance policies, contracts, and state health programs, while excluding certain types of plans like dental, vision, and disability insurance. The effective date for this mandate is January 1, 2026. The bill also outlines the process for the Insurance Commissioner, the Secretary of the Department of Human Services, and the State Board of Finance to promulgate necessary rules to implement this act. These rules must be filed by specific deadlines to ensure timely implementation.
Potential Impact Analysis
Who Might Benefit?
The primary beneficiaries of this bill are infants and their families in Arkansas. By mandating coverage for respiratory syncytial virus (RSV) disease immunization technologies, the bill aims to increase access to preventative care for infants, thereby reducing the incidence and severity of RSV infections. Health insurance providers, including those offering individual, blanket, or group plans, as well as state health programs like Medicaid, will be required to offer this coverage. Medical professionals and pharmaceutical companies involved in providing and administering RSV immunizations will also see increased utilization of their services and products.
Who Might Suffer?
The primary entities that may be negatively impacted by this bill are healthcare insurers and health benefit plans operating within Arkansas. The mandate to cover RSV immunization technologies for infants without imposing typical cost-sharing mechanisms like deductibles, copayments, or coinsurance could increase the financial liability for these insurers. This potential increase in costs may, in turn, lead to adjustments in premiums for all covered individuals or a reassessment of other coverage benefits. Additionally, self-insured governmental and church plans operating in Arkansas would also be subject to this coverage mandate, potentially affecting their financial planning.