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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
Regular Session, 2012 ENROLLED
SENATE BILL NO. 231
BY SENATORS MURRAY, MI LLS AND THOMPSON AND REPRESENTATI VE
THIBAUT
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. As used in this Section:8
(1) "Health insurance issuer" means any entity that offers health9
insurance coverage through a plan, policy, or certificate of insurance subject to10
state law that regulates the business of insurance. "Health insurance issuer"11
shall also include a health maintenance organization, as defined and licensed12
pursuant to Subpart I of Part I of Chapter 2 of this Title.13
(2) "Health benefit plan", "plan", "benefit", or "health insurance14
coverage" means services consisting of medical care, provided directly, through15
insurance or reimbursement, or otherwise, and including items and services16
paid for as medical care under any hospital or medical service policy or17
certificate, hospital or medical service plan contract, preferred provider18
organization, or health maintenance organization contract offered by a health19
insurance issuer. However, excepted benefits are not included as a "health20
benefit plan".21
(3) "Prior authorization" shall mean a utilization management criterion22
utilized to seek permission or waiver of a drug to be covered under a health23
benefit plan that provides prescription drug benefits.24
ACT No. 318 SB NO. 231 ENROLLED
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
(4) "Prior authorization form" shall mean a standardized, uniform1
application developed by a health insurance issuer for the purpose of obtaining2
prior authorization.3
B. Notwithstanding any other provision of law to the contrary, in order4
to establish uniformity in the submission of prior authorization forms, on and5
after January 1, 2013, a health insurance issuer shall utilize only a single,6
standardized prior authorization form for obtaining any prior authorization for7
prescription drug benefits. The form shall not exceed two pages in length,8
excluding any instructions or guiding documentation. A health insurance issuer9
may make the form accessible through multiple computer operating systems.10
Additionally, the health insurance issuer shall submit its prior authorization11
forms to the Department of Insurance to be kept on file on or after January 1,12
2013. A copy of any subsequent replacements or modifications of a health13
insurance issuer's prior authorization form shall be filed with the Department14
of Insurance within fifteen days prior to use or implementation of such15
replacements or modifications.16
Section 2. This Act shall become effective upon signature by the governor or, if not17
signed by the governor, upon expiration of the time for bills to become law without signature18
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If19
vetoed by the governor and subsequently approved by the legislature, this Act shall become20
effective the day following such approval.21
PRESIDENT OF THE SENATE
SPEAKER OF THE HOUSE OF REPRESENTATIVES
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED: