Cancer survivors in Arkansas just got a big win over their insurance companies

New law covers all breast reconstruction types

Arkansas now requires health insurers to cover every type of medically necessary breast reconstruction surgery.

Act 424 took effect on Jan. 1, 2026, and it changes the game for patients who need procedures after a mastectomy, disease, trauma, or preventive surgery.

The key shift: treatment decisions now stay between the patient and their doctor, based on medical standards, not what an insurance company wants to pay for.

Lawmakers passed the bill unanimously

Act 424 started as Senate Bill 83, introduced in January 2025.

State Sen. Joshua Bryant, a Republican from Benton County, sponsored the bill alongside Rep. Kendra Moore.

It sailed through the Arkansas Senate with a 33-0 vote, and Gov. Sarah Huckabee Sanders signed it into law on April 3, 2025.

That kind of bipartisan support is rare on health care bills, but this one brought both sides together quickly.

Patients traveled thousands of miles for surgery

Before this law, many Arkansas patients had no choice but to leave the state for advanced breast reconstruction. Some traveled thousands of miles because their insurers refused to cover certain procedures close to home.

That meant time away from family, local doctors, and the support systems people lean on during recovery. Sen. Bryant said the law was about making sure patients can stay near their loved ones for critical care.

DIEP flap surgery takes center stage

One procedure drove much of the push for this law: DIEP flap surgery.

The name stands for Deep Inferior Epigastric Perforator flap, and it uses skin and fatty tissue from the patient’s abdomen to rebuild the breast.

Unlike older methods, it does not cut or move muscle, which means patients keep their core strength. The surgery is complex, though.

A single operation can take eight to 12 hours.

Low pay kept surgeons from offering it

Before Act 424, insurers paid so little for DIEP flap surgery that hospitals lost money every time they performed it. That created a simple but painful problem: doctors stopped offering it.

When the bill was introduced, only one hospital in the entire state performed the procedure.

The law now sets minimum payment rates for breast reconstruction surgeries, which should bring more providers to the table.

Federal law left a loophole insurers used

The Women’s Health and Cancer Rights Act of 1998 requires health plans that cover mastectomy to also cover reconstruction. But that federal law never spelled out which types of reconstruction insurers had to pay for.

That gray area gave insurance companies room to deny or underpay for advanced procedures like DIEP flap. Arkansas Act 424 fills the gap by requiring coverage for all methods of reconstruction, not just the cheapest ones.

Patients get new financial protections too

The law does more than just mandate coverage. If an insurer’s network does not include a qualified surgeon for a recommended procedure, the company must approve a deal with an out-of-network provider.

Even then, the patient only pays in-network rates. The law also creates penalties for insurers who make late payments or fail to pay altogether.

Coverage applies to any health plan offered, issued, or renewed in Arkansas on or after Jan. 1, 2026.

Three more laws strengthen cancer care

Act 424 is part of a bigger package Arkansas passed in 2025.

Act 553 eliminates out-of-pocket costs for diagnostic breast exams, cancer screenings, and supplemental imaging like MRIs and ultrasounds.

Act 561 expands mastectomy-related coverage to include things like artificial mesh and nerve grafts. Act 860 requires coverage for genetic testing for inherited gene mutations in certain cases.

Together, these four laws reshape how the state handles breast cancer care.

Nearly 2,400 Arkansas women get diagnosed yearly

About 2,400 women in Arkansas receive a breast cancer diagnosis each year, and more than 400 lose their lives to the disease annually. Nationally, more than 300,000 women are diagnosed every year.

The federal law passed in 1998 was a big step at the time, but advocates say it has not kept pace with how far surgical options have come in the decades since.

Congress considers updating the federal law

The national conversation around reconstruction coverage has been heating up.

In 2023, a federal billing code change nearly wiped out insurance coverage for DIEP flap surgery across the country.

After public pressure, the Centers for Medicare and Medicaid Services reversed course and kept the billing codes.

Then in October 2025, lawmakers introduced a bipartisan bill called the Advancing Women’s Health Coverage Act to modernize the 1998 federal law. Arkansas is one of the states that decided not to wait.

What Arkansas patients need to know now

The law covers all health benefit plans offered, issued, or renewed in Arkansas on or after Jan. 1, 2026.

If your plan was renewed before that date, you should check with your insurer to find out when the new rules kick in for you. The bottom line: your doctor, not your insurance company, guides your treatment decisions.

And if your insurer’s network cannot provide the surgery you need, you are protected from higher out-of-network costs.

This article was created with AI assistance and human editing.

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