AL HB453

Requires all Alabama health insurance plans, including private insurance, public employee plans, and Medicaid, to cover breast reconstruction surgery beginning January 1, 2027

Allows patients to choose any board-certified plastic surgeon and any reconstruction method, including out-of-network providers, while paying only in-network cost-sharing rates

Covers comprehensive reconstruction services including all stages of surgery, symmetry procedures on the opposite breast, nipple reconstruction, flat closure, prostheses, and treatment of complications

Requires insurers to respond to prior authorization requests within 3 business days and establishes a presumption of medical necessity for patient-chosen reconstruction methods

Creates enforcement mechanisms allowing patients and providers to bring civil lawsuits for insurer non-compliance, with potential treble damages for knowing violations, and grants concurrent enforcement authority to the Attorney General and Insurance Commissioner