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Arkansas General Assembly· HB 1052WITHDRAWN BY AUTHOR

An act TO MANDATE COVERAGE FOR CERTAIN RESPIRATORY 10 SYNCYTIAL VIRUS DISEASE IMMUNIZATION TECHNOLOGIES FOR 11 CERTAIN INDIVIDUALS, the official text

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Stricken language would be deleted from and underlined language would be added to present law.

1 State of Arkansas                         A Bill
2 95th General Assembly

3 Regular Session, 2025                                         HOUSE BILL 1052

4

5 By: Representatives Gramlich, L. Johnson

6 By: Senator J. Boyd

7

8                        For An Act To Be Entitled

9   AN ACT TO MANDATE COVERAGE FOR CERTAIN RESPIRATORY

10  SYNCYTIAL VIRUS DISEASE IMMUNIZATION TECHNOLOGIES FOR

11  CERTAIN INDIVIDUALS; AND FOR OTHER PURPOSES.

12

13

14                                          Subtitle

15                       TO MANDATE COVERAGE FOR CERTAIN

16                       RESPIRATORY SYNCYTIAL VIRUS DISEASE

17                       IMMUNIZATION TECHNOLOGIES FOR CERTAIN

18                       INDIVIDUALS.

19

20 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:

21

22  SECTION 1. Arkansas Code Title 23, Chapter 79, is amended to add an

23 additional subchapter to read as follows:

24

25  Subchapter 29 -- Coverage for Monoclonal Antibodies for Immunization of

26                       Respiratory Syncytial Virus Disease

27

28  23-79-2901. Definitions.

29  As used in this subchapter:

30  (1)(A) "Health benefit plan" means:

31                       (i) An individual, blanket, or group plan or a policy

32 or contract for healthcare services offered, issued, renewed, delivered, or

33 extended in this state by a healthcare insurer; and

34                       (ii) A health benefit program receiving state or 35

35 federal appropriations from the State of Arkansas, including the Arkansas

36 Medicaid Program and the Arkansas Health and Opportunity for Me Program, �

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1 23-61-1001 et seq., or any successor program.

2            (B) "Health benefit plan" includes:

3                         (i) Indemnity and managed care plans; and

4                         (ii) Nonfederal governmental plans as defined in 29

5 U.S.C. � 1002(32), as it existed on January 1, 2025.

6            (C) "Health benefit plan" does not include:

7                         (i) A plan that provides only dental benefits or eye

8 8 and vision care benefits;

9                         (ii) A disability income plan;

10                        (iii) A credit insurance plan;

11                        (iv) Insurance coverage issued as a supplement to

12 liability insurance;

13                        (v) A medical payment under an automobile or

14 homeowners insurance plan;

15                        (vi) A health benefit plan provided under Arkansas

16 Constitution, Article 5, � 32, the Workers' Compensation Law, � 11-9-101 et

17 17 seq., or the Public Employee Workers' Compensation Act, � 21-5-601 et

18 seq.;

19                        (vii) A plan that provides only indemnity for 19

20 hospital confinement;

21                        (viii) An accident-only plan;

22                        (ix) A specified disease plan; or

23                        (x) A long-term-care-only plan;

24           (2)(A) "Healthcare insurer" means an entity subject to the

25 insurance laws of this state or the jurisdiction of the Insurance

26 Commissioner that contracts or offers to contract to provide health insurance

27 coverage, including without limitation an insurance company, a hospital and

28 medical service corporation, a health maintenance organization, a self-

29 insured governmental or church plan in this state, or the Arkansas Medicaid

30 Program.

31           (B) "Healthcare insurer" does not include an entity that

32 provides only dental benefits or eye and vision care benefits;

33        (3) "Infant" means a child less than eight (8) months old; and

34        (4) "Respiratory syncytial virus disease" means a respiratory infection

35 of the nose, throat, and lungs caused by the respiratory syncytial virus.

36

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1   23-79-2902. Coverage for monoclonal antibodies for immunization --

2 Respiratory syncytial virus disease.

3   (a) Beginning on and after January 1, 2026, a health benefit plan that

4 is offered, issued, renewed, delivered, or extended in this state shall

5 provide coverage for monoclonal antibodies for immunization of respiratory

6 syncytial virus disease of an infant under guidelines issued by the United

7 States Food and Drug Administration.

8   (b) The coverage for monoclonal antibodies for immunization of

9 respiratory syncytial virus disease of an infant under subsection (a) of this

10 section:

11           (1) Is not subject to an annual deductible, copayment, or

12 coinsurance limit as established for other covered benefits under a health

13 benefit plan; and

14           (2) Does not diminish or limit benefits otherwise allowable under

15 a health benefit plan.

16

17  SECTION 2. TEMPORARY LANGUAGE. DO NOT CODIFY. Rules.

18  (a)(1) Except as provided in subdivisions (a)(2) and (3) of this

19 section, the Insurance Commissioner shall promulgate rules necessary to

20 implement this act.

21           (2) The Secretary of the Department of Human Services shall

22 promulgate rules necessary to implement this act that may apply to the

23 Arkansas Medicaid Program or the Arkansas Health and Opportunity for Me

24 Program, � 23-61-1001 et seq.

25           (3) The State Board of Finance shall promulgate rules necessary

26 to implement this act that may apply to the State and Public School Life and

27 Health Insurance Program.

28  (b) When adopting the initial rules required under this act, the

29 commissioner, secretary, and the board shall file the final rules with the

30 Secretary of State for adoption under � 25-15-204(f):

31           (1) On or before January 1, 2026; or

32           (2) If approval under � 10-3-309 has not occurred by January 1,

33 2026, as soon as practicable after approval under � 10-3-309.

34  (c) The commissioner, secretary, and board shall file the proposed

35 rules with the Legislative Council under � 10-3-309(c) sufficiently in

36 advance of January 1, 2026, so that the Legislative Council may consider the

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 1 rules for approval before January 1, 2026.                                                                      HB1052
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