The bill amends the Arkansas Medicaid Program's coverage for continuous glucose monitors by allowing beneficiaries to obtain these devices through either a prescription at a pharmacy or a written order from a practitioner for durable medical equipment. Specifically, it replaces the phrase "a prescription" with "A" and introduces a new option for obtaining the monitor through durable medical equipment providers. Additionally, it clarifies that durable medical providers are not required to submit a National Drug Code as part of any claim submission.

Furthermore, the bill establishes that regardless of the source of coverage—whether through a pharmacy or a durable medical equipment provider—the Department of Human Services must implement consistent approval requirements and ensure reimbursement for continuous glucose monitors provided by durable medical equipment providers at a rate no less than the Medicare reimbursement under the Healthcare Common Procedure Coding System. This aims to streamline the process and ensure equitable access to necessary medical devices for beneficiaries.

Statutes affected:
Old version HB1255 Original - 1-27-2025 02:47 PM: 20-77-148(c), 20-77-148
Old version HB1255 V2 - 4-3-2025 09:18 AM: 20-77-148(c), 20-77-148, 04-03-2025
HB 1255: 20-77-148(c), 20-77-148
Act 857: 20-77-148(c), 20-77-148, 04-03-2025