HB1252

House Bill 1252 modifies the Arkansas Health Care Consumer Act to expand insurance coverage requirements for prosthetic devices. It mandates that health benefit plans cover prosthetic devices specifically designed for athletics, recreation, and showering or bathing. The bill sets eligibility standards based on medical necessity and functional level assessments, specifically requiring patients to meet a K-3 or K-4 functional level for recreational prosthetics. It allows insurers to require prior authorization and apply standard cost-sharing measures such as copayments, deductibles, and coinsurance. Additionally, the bill outlines criteria for the repair and replacement of these devices due to anatomical changes or normal wear. Finally, it authorizes the Insurance Commissioner to adopt rules to implement and enforce these new coverage requirements.