SLS 12RS-596 ORIGINAL
Page 1 of 3
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
Regular Session, 2012
SENATE BILL NO. 231
BY SENATOR MURRAY
HEALTH/ACC INSURANCE. Provides relative to prior authorization forms. (gov sig)
AN ACT1
To enact R.S. 22:1006.1, relative to prior authorization forms; to provide with respect to the2
issuance and use of prior authorization forms; to provide for an effective date; and3
to provide for related matters.4
Be it enacted by the Legislature of Louisiana:5
Section 1. R.S. 22:1006.1 is hereby enacted to read as follows:6
ยง1006.1. Prior authorization forms required; criteria7
A. Notwithstanding any other provisions of law, on and after January8
1, 2013, a health insurance issuer that provides prescription drug benefits shall9
accept only the prior authorization form developed pursuant to Subsection C10
of this Section when requiring prior authorization for prescription drug11
benefits.12
B. If a health insurance issuer fails to utilize or accept the prior13
authorization form, or fails to respond within two business days upon receipt14
of a completed prior authorization request from a prescribing provider,15
pursuant to the submission of the prior authorization form developed as16
described in Subsection C, the prior authorization request shall be deemed to17 SB NO. 231
SLS 12RS-596 ORIGINAL
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
have been granted.1
C. The department of insurance shall develop a uniform prior2
authorization form. Notwithstanding any other provision of law to the3
contrary, on and after January 1, 2013, every health insurance issuer shall use4
such uniform prior authorization form to request prior authorization for5
coverage of prescription drug benefits and every health care service plan shall6
accept such form as sufficient to request prior authorization for prescription7
drug benefits.8
D. The prior authorization form developed pursuant to Subsection C of9
this Section shall meet the following criteria:10
(1) The form shall not exceed two pages.11
(2) The form shall be made available electronically by the department12
and the health care service plan.13
(3) The completed form may also be submitted electronically from the14
prescribing provider to the health care service plan.15
(4) The department of insurance shall develop the form with input from16
interested parties received at one or more public meetings.17
(5) The department of insurance, in developing the standardized form,18
shall take into consideration the following:19
(a) Existing prior authorization forms established by the federal Centers20
for Medicare and Medicaid Services and the Department of Health and Human21
Hospitals.22
(b) National standards, or draft standards, pertaining to electronic prior23
authorization.24
Section 2. Effective upon signature of the governor or lapse of time for gubernatorial25
action.26 SB NO. 231
SLS 12RS-596 ORIGINAL
Page 3 of 3
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Cheryl Horne.
DIGEST
Proposed law applicable on and after January 1, 2013, requires a health insurance issuer that
provides prescription drug benefits to use and accept only the prior authorization form
developed by the department of insurance. Further provides that if a health insurance issuer
fails to utilize or accept the form, or fails to respond within 2 business days of receipt, the
prior authorization request shall be deemed granted.
Proposed law establishes the criteria for the prior authorization form to include electronic
availability and submission as well as consideration of existing prior authorization forms
established by the federal Centers for Medicare and Medicaid Services and the Dept. of
Health and Hospitals, and national standards.
Effective upon signature of the governor or lapse of time for gubernatorial action.
(Adds R.S. 22:1006.1)