Provides for modification and renewability of certain health insurance plan provisions. (gov sig) (EN NO IMPACT See Note)
Impact
The passage of SB206 would significantly impact state laws governing health insurance policies. By requiring coverage continuity for prescription drugs, it ensures that individuals and groups are not suddenly deprived of access to necessary medications, thereby improving patient care and adhering to a patient-centered approach in health insurance. Moreover, the bill modifies existing requirements, allowing issuers to adjust drug coverage without having to seek approval from the state commissioner, potentially streamlining the process but also raising concerns about oversight.
Summary
Senate Bill 206, introduced by Senator Morrish, amends provisions related to health benefit plans in Louisiana. Specifically, this bill addresses the continuation and modification of health insurance coverage, particularly concerning prescription drugs. It mandates that health insurance issuers must offer coverage for any prescription drugs approved under a health plan until the plan's renewal date, even if those drugs have been removed from the plan's formulary. This is aimed at ensuring that enrollees retain access to the medications they need without interruption due to formulary changes.
Sentiment
General sentiment around SB206 appears to be supportive among legislators, as indicated by the overwhelming voting results of 96 in favor and just 1 against during the final passage in the House. Proponents argue that this bill is crucial for maintaining drug coverage stability and for reinforcing consumer rights in health insurance. However, there may be underlying concerns regarding the lack of commissioner oversight in modifications affecting drug coverage, which some stakeholders might view as a potential risk to comprehensive care.
Contention
While the sentiment has largely been positive, there are notable points of contention regarding the implications of allowing drug coverage modifications without commissioner approval. Critics may argue that this could lead to less accountability and transparency in how insurance companies manage formulary changes, potentially impacting patient access to specific medications. The discussion also touches upon the balance between regulatory oversight and the flexibility needed for insurance issuers, making it a topic of significant interest in the realm of state healthcare policy.
Authorizes modification of drug coverage for a drug costing over $300 per prescription or refill with an increase of at least 25% in the prior 365 days under certain circumstances if 30-day notice is given. (8/1/20)