The proposed bill mandates coverage for treatments related to severe obesity under the Arkansas Medicaid Program and private health benefit plans. It introduces a new section in the Arkansas Code that requires reimbursement for medically necessary treatments for diseases and conditions caused by severe obesity, which includes bariatric surgery, preoperative care, and post-operative care. The bill specifies that coverage will not extend to injectable drugs for glucose levels or weight loss. Additionally, it outlines the qualifications for individuals to receive coverage, including the necessity of a healthcare provider's written order and participation in a weight loss program.
Furthermore, the bill establishes definitions related to severe obesity, including body mass index (BMI) criteria, and sets forth limitations and exclusions for coverage. It allows healthcare insurers to impose a preoperative period of up to three months for counseling and education, and restricts coverage to individuals aged 18 and older. The bill also empowers the Insurance Commissioner to create rules for additional preoperative conditions and coverage requirements based on industry best practices. Overall, the legislation aims to enhance access to necessary obesity treatments while maintaining certain restrictions and guidelines.