Women's Health Rights and Cancer Act - Arkansas

Summary of differences between federal and state regulations

Employee health plans are generally covered under the federal jurisdiction of the Employee Retirement Income Security Act (ERISA). Laws for women specifically include the Women’s Health and Cancer Rights Act of 1998, and Newborns’ and Mothers’ Health Protection Act of 1996. State insurance laws, however, do apply. The federal laws regarding women’s health rights include the following provisions:

• If the plan covers mastectomies, it must cover all stages of reconstruction of the breast on which the mastectomy has been performed; surgery and reconstruction of the other breast to produce a symmetrical appearance; and prostheses and physical complications of mastectomy, including lymphedemas in a manner determined in consultation with the attending physician and the patient. (Women’s Health Rights and Cancer Act)
• If the group health plan provides maternity coverage, it must cover at least a 48-hour hospital stay following childbirth (96-hour stay in the case of Cesarean section). (Newborns' and Mothers' Health Protection Act)

The state includes the following provisions:

• Plans may not restrict benefits for any hospital stay in connection with childbirth for the mother or newborn child to less than 48 hours following a normal vaginal delivery or to less than ninety-six 96 hours following cesarean section. §23-99-404
• A baseline mammogram for a woman covered by such a policy who is 35 to 40 years old; a mammogram 40 to 49 years old, every one to two years based on the recommendation of the woman's physician; a mammogram each year for a woman covered by such a policy who is at least 50 years old age; and upon recommendation of a woman's physician, without regard to age, when the woman has had a prior history of breast cancer or when the woman's mother or sister has had a history of breast cancer. Insurance coverage for screening mammograms will not prejudice coverage for diagnostic mammograms as recommended by the woman's physician. §23-79-140
• All accident and health insurance companies doing business in this state shall include, as a covered expense, in vitro fertilization. §23-86-118
• With the passage of HB 2618 (Equity in Prescription Insurance and Contraceptive Coverage Act), if the plan covers prescription drugs on an outpatient basis, it must cover prescribed contraceptive drugs or devices approved by the FDA. §23-79-1103

State

Contact

Arkansas Insurance Department

Regulations

Arkansas Code Title 23, Chapter 79, Insurance Policies Generally

Equity in Prescription Insurance and Contraceptive Coverage Act

Insurance Coverage for Contraception Laws

Federal

Contact

Employee Benefits Security Administration (EBSA)

Regulations

See the text of the Women’s Health and Cancer Rights Act under Acts/Laws, Title 1, Subtitle B, Part 7, Subpart B; and the U.S. Code, Title 29, chapter 18, §1185b.

See also U. S. Code Title 29, chapter 18, §1185 for laws regarding mothers.

29 CFR 1604.10 (Employment policies relating to pregnancy and childbirth)

29 CFR chapter XXV (Parts 2509 – 2590)