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 healthcare practitioner for durable medical equipment. Specifically, it replaces the phrase "a prescription" with "A" and adds a new provision that enables beneficiaries to receive the monitor as a durable medical equipment benefit. Additionally, it states that durable medical providers are not required to submit a National Drug Code when filing claims for these devices.

Furthermore, the bill introduces a new subsection that mandates the Department of Human Services to implement consistent approval requirements for coverage, regardless of whether the continuous glucose monitor is obtained through a pharmacy or a durable medical equipment provider. It also ensures that reimbursement for monitors provided by durable medical equipment providers will be no less than the Medicare reimbursement rate under the Healthcare Common Procedure Coding System.

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