Provides relative to health insurance coverage modifications and unfair or deceptive practices. New law retains prior law but as to the notification requirement, modification of drug coverage is allowed at any time as to a drug increasing over $300 per prescription or refill with an increase in the wholesale acquisition cost of at least 25% in the prior 365 days provided that 30-day notice of the modification of coverage is given. New law requires that the 30-day notice of modification of coverage include information on the issuer's process for an enrollee's physician to request [...]
Provides relative to insurance cost-sharing practices. New law retains prior law and specifies that for the definition of "pharmacy benefit manager", the management or administration of a benefit plan may include review, processing of drug prior authorization requests, adjudication of appeals and grievances related to the prescription drug benefit, contractingwith network pharmacies, and controlling the cost of covered prescription drugs. New law provides for fairness in enrollee cost-sharing. Defines terms for purposes of proposed law, including "cost-sharing requirement", "enrollee", "health benefit plan", "healthcare services", "health insurance issuer", and "person".
Provides for payment of health insurance provider claim payment claims. Provides that any health insurance plan, except the La. Medicaid Program, that issued, amended, or renewed on or after January 1, 2022, shall not restrict the method of payment from the health insurance issuer or its vendor to the health care provider in which the only acceptable method for healthcare services rendered requires the health care provider to pay a transaction fee, provider subscription fee, or any other type of fee or cost in order to accept payment from the health insurance issuer.
Provides for definitions and exemptions relative to telemedicine and telehealth. New law provides that no provision of existing law regulating the practice of medicine shall applyto a consultation without limitation between a practicing physician licensed in this state and a practicing physician licensed in another state or jurisdiction.
Provides relative to telehealth services provided by licensed hearing aid dealers. New law retains prior law and adds licensed hearing aid dealers to the definition health care provider included in the Louisiana Telehealth Access Act.
Authorizes the establishment of a state-based health insurance exchange and assessments thereto. Proposed law authorizes the commissioner of insurance to assess a fee from insurers offering health insurance coverage through a La.-based health insurance exchange. Requires the assessment from insurers not to exceed 2% of the amount of premiums received by the insurers during the previous calendar year. Further provides for the fee to be assessed by and made payable to the commissioner annually between July 1 and July 30. Proposed law requires each insurer to file with the commissioner, on a form prescribed [...]
Provides for external review of health insurance issuers. New law removes dental insurance plans from the exclusion and provides that they are subject to provisions of the Health Insurance Issuer External Review Act.
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See Louisiana page. Louisiana has been active in legislative efforts to promote price transparency in health care. In recent terms, the state legislature introduced bills to tackle surprise billing by out-of-network specialists, proposing that patients should only be responsible for deductibles and copayment amounts that they would under the in-network terms of their insurance plans. The legislature is [...]
Newly available on the Source: our health policy research team compiled a user-friendly, downloadable Excel spreadsheet of all provider merger review authority for all 50 states, now on the Market Consolidation interactive key issue page. The detailed chart provides clickable citations of all statutes, regulations, and state authority for mergers, acquisitions, conversions, or changes in ownership of healthcare providers. The comprehensive spreadsheet allows side-by-side comparisons of the level of legal authority for each state to receive notice of impending transactions, review those transactions, and approve, conditionally approve, or disapprove them. It is conveniently organized [...]
Provides relative to non-competition agreements for physicians. Proposed law retains present law and prohibits noncompete contract clauses that restrict primary care physicians, regardless of employer, or any physician employed by the state from the practice of medicine. Proposed law prohibits noncompete clauses from being enforced upon a physician specialist not employed by the state if he has served under the employer or contractor for three years or greater.