HB1121

House Bill 1121 requires health benefit plans in Arkansas to provide coverage for biomarker testing used in the diagnosis, treatment, and management of cancer. The bill establishes definitions for relevant terms and outlines criteria for when biomarker testing must be covered, such as when supported by FDA-approved indications, national clinical guidelines, or consensus statements. It mandates that coverage be provided in a manner that limits patient disruptions, such as the need for repeated biopsies. Additionally, the bill requires insurers to establish a clear and convenient exception process for subscribers. It also sets specific timelines for utilization review entities to approve or deny prior authorization requests for testing, requiring decisions within 72 hours for non-urgent requests and 24 hours for urgent requests. The legislation explicitly excludes several plan types, including Medicaid and workers' compensation, from these requirements.