ENROLLED
Page 1 of 4
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
ACT No. 410
Regular Session, 2012
HOUSE BILL NO. 693
BY REPRESENTATIVES CROMER, ADAMS, ANDERS, ARNOLD, BADON,
BERTHELOT, BILLIOT, WESLEY BISHOP, BROSSETT, BROWN, BURFORD,
HENRY BURNS, CARTER, CHANEY, CONNI CK, COX, DIXON, DOVE,
EDWARDS, FANNIN, FOIL, GAROFALO, GUILLORY, HARRIS, HARRISON,
HAVARD, HAZEL, HENRY, HILL, HODGES, HOFFMANN, HOWARD,
HUNTER, HUVAL, JAMES, JOHNSON, JONES, KLECKLEY, NANCY
LANDRY, TERRY LANDRY, LEBAS, LEGER, LIGI, LOPINTO, LORUSSO,
MILLER, MONTOUCET, MORENO, JAY MORRIS, PIERRE, PONTI, POPE,
PUGH, PYLANT, REYNOLDS, RI CHARD, RICHARDSON, RITCHIE,
SCHEXNAYDER, SCHRODER, SIMON, SMITH, ST. GERMAIN, TALBOT,
THIBAUT, THIERRY, THOMPSON, WHITNEY, AND WILLMOTT AND
SENATORS ALARIO, AMEDEE, BROOME, BROWN, CHABERT, JOHNS,
LAFLEUR, MORRISH, GARY SMITH, WARD, AND WHITE
AN ACT1
To enact R.S. 22:999.1, relative to health insurance issuers which provide coverage for2
cancer treatment; to require that such issuers provide for parity for orally3
administered anti-cancer medications with intravenously administered or injected4
anti-cancer medications; to provide for definitions; to provide for applicability; and5
to provide for related matters.6
Be it enacted by the Legislature of Louisiana:7
Section 1. R.S. 22:999.1 is hereby enacted to read as follows:8
ยง999.1. Parity for orally administered anti-cancer medications with intravenously9
administered or injected anti-cancer medications10
A. It is hereby declared that the public policy of this state is that every11
person within this state with health insurance coverage that provides coverage for12
cancer treatment shall have access to the type of covered medication used to treat his13
cancer, as such a decision affects the person's overall, long-term health and quality14
of life. It is also declared that orally administered anti-cancer medications, although15
very effective in killing or slowing the growth of cancerous cells, have high out-of-16
pocket costs to the covered person, impacting the decision of physicians to prescribe17
such medications, thus restricting patient access to life-saving oral anti-cancer18 ENROLLEDHB NO. 693
Page 2 of 4
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
medications. It is further declared that physicians must be able to make the best1
choice for their patients, considering the unique aspects of each patient and the2
progress of the disease.3
B.(1) A health insurance issuer that provides coverage for cancer treatment4
shall provide for coverage of prescribed orally administered anti-cancer medications5
on a basis no less favorable than intravenously administered or injected cancer6
medications.7
(2) Health insurance coverage of orally administered anti-cancer medications8
shall not be subject to any prior authorization, dollar limit, copayment, deductible,9
or other out-of-pocket expense that does not apply to intravenously administered or10
injected cancer medications, regardless of formulation or benefit category11
determination by the health insurance issuer.12
(3) A health insurance issuer shall not reclassify or increase any type of cost-13
sharing to the covered person for anti-cancer medications in order to achieve14
compliance with this Section. Any change in health insurance coverage that15
otherwise increases an out-of-pocket expense applied to anti-cancer medications16
shall also be applied to the majority of comparable medical or pharmaceutical17
benefits covered by the health insurance issuer.18
(4) A health insurance issuer that limits the total amount paid by a covered19
person through all cost-sharing requirements to no more than one hundred dollars per20
filled prescription for any orally administered anti-cancer medication shall be21
considered in compliance with this Section. For purposes of this Paragraph, "cost-22
sharing requirements" shall include copayments, coinsurance, deductibles, and any23
other amounts paid by the covered person for that prescription.24
C. As used in this Section:25
(1) "Anti-cancer medications" means medications used to kill or slow the26
growth of cancer cells.27 ENROLLEDHB NO. 693
Page 3 of 4
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
(2) "Covered person" means a policyholder, subscriber, enrollee, or other1
individual enrolled in or insured by a health insurance issuer for health insurance2
coverage.3
(3) "Health insurance coverage" or "coverage" means benefits consisting of4
medical care provided or arranged for directly, through insurance or reimbursement,5
or through a network, and including services paid for as medical care under any6
hospital or medical service policy or certificate, hospital or medical service plan7
contract, preferred provider organization agreement, or health maintenance8
organization contract offered by a health insurance issuer.9
(4) "Health insurance issuer" means any entity that offers health insurance10
coverage through a policy or certificate of insurance subject to state law that11
regulates the business of insurance. For purposes of this Section, a "health insurance12
issuer" shall include a health maintenance organization, as defined and licensed13
pursuant to Subpart I of Part I of Chapter 2 of this Title, nonfederal government14
plans subject to the provisions of Subpart B of this Part, and the Office of Group15
Benefits.16
(5) "Network of providers" or "network" means an entity other than a health17
insurance issuer that, through contracts with health care providers, provides or18
arranges for access by groups of covered persons to covered health care services by19
health care providers who are not otherwise or individually contracted directly with20
a health insurance issuer.21
D. The provisions of this Section shall not apply to the following:22
(1) Limited benefit health insurance policies or contracts.23
(2) High deductible health plans or policies that are qualified to be used in24
conjunction with a health savings account, a medical savings account, or other25
similar program authorized by 26 U.S.C. 220 et seq.26
(3) Qualified health plans offered through a health benefit exchange.27 ENROLLEDHB NO. 693
Page 4 of 4
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
Section 2. This Act shall be applicable to health insurance coverage that provides1
coverage for cancer treatment issued for delivery, delivered, renewed, or otherwise2
contracted for in this state on or after January 1, 2013.3
SPEAKER OF THE HOUSE OF REPRESENTATI VES
PRESIDENT OF THE SENATE
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED: