AR HB1121

Health benefit plans offered, issued, or renewed in Arkansas must provide coverage for biomarker testing for cancer diagnosis, treatment, management, and monitoring when supported by medical and scientific evidence.

Covered evidence includes FDA-approved or cleared tests, FDA-approved drugs with indicated tests, CMS coverage determinations, and nationally recognized clinical practice guidelines or consensus statements.

Health benefit plans must limit disruptions in care, including unnecessary multiple biopsies and biospecimen samples, as determined by healthcare professionals.

Subscribers and healthcare professionals have access to a clear, readily available process to request exceptions to coverage decisions, which must be accessible on the plan's website.

Utilization review entities must approve or deny prior authorization requests within 72 hours for nonurgent services or 24 hours for urgent healthcare services related to biomarker testing.