HB1052
To Mandate Coverage For Certain Respiratory Syncytial Virus Disease Immunization Technologies For Certain Individuals.
Last Action (Nov. 25, 2024): WITHDRAWN BY AUTHOR
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AI-Generated Summary
House Bill 1052 mandates that health benefit plans in Arkansas provide coverage for monoclonal antibody immunizations for respiratory syncytial virus (RSV) in infants under eight months old, effective January 1, 2026. This mandate applies to a wide range of insurance providers, including private plans, the Arkansas Medicaid Program, the Arkansas Health and Opportunity for Me Program, and nonfederal governmental plans. The bill specifies that this coverage must be provided without the application of annual deductibles, copayments, or coinsurance limits. Additionally, the coverage mandated by the bill must not diminish or limit other benefits provided under a health plan. State agencies, including the Insurance Commissioner, the Department of Human Services, and the State Board of Finance, are directed to promulgate the necessary rules for implementation by January 1, 2026. The bill specifically excludes certain types of specialized insurance, such as dental-only or accident-only plans, from these requirements.
Potential Impact Analysis
Who Might Benefit?
The primary beneficiaries are infants under eight months old and their families, as the bill ensures access to RSV immunization technology without out-of-pocket costs such as deductibles, copayments, or coinsurance. Healthcare providers and pediatric medical facilities also benefit from increased coverage, which may improve immunization rates and reduce the incidence of severe RSV cases requiring intensive medical care.
Who Might Suffer?
Health insurance companies and self-insured plans, including state-funded programs like Medicaid, may be negatively impacted by increased operational and coverage costs mandated by the legislation. Additionally, employers or government entities that provide or fund health insurance benefits may face increased premium costs as insurers pass on the expenses associated with this mandatory, no-cost coverage.
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