HLS 14RS-161 ORIGINAL
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
Regular Session, 2014
HOUSE BILL NO. 601
BY REPRESENTATIVE ABRAMSON
INSURANCE/HEALTH: Prohibits a provider of healthcare services from refusing to
submit a claim to a healthcare insurance issuer under certain circumstances
AN ACT1
To enact R.S. 22:1827, relative to health insurance coverage; to prohibit a provider of2
healthcare services from refusing to submit a claim to a health insurance issuer under3
certain circumstances; to define certain terms; and to provide for related matters.4
Be it enacted by the Legislature of Louisiana:5
Section 1. R.S. 22:1827 is hereby enacted to read as follows:6
ยง1827. Submission of health insurance claims7
A.(1) A provider of healthcare services shall not require an insured, as a8
condition for the submission of a claim for payment by a healthcare insurer or the9
furnishing of healthcare services, to consent to full payment for the services in the10
event that the insured's health insurance issuer denies the claim for health insurance11
service.12
(2) This Section shall not preclude such a provider from requiring the13
insured to pay the provider directly for such healthcare services in the event such a14
claim is subsequently denied by the healthcare issuer after submission but before the15
services are provided and such services are still requested by the insured.16
B. For purposes of this Section:17
(1) "Healthcare services" means services, items, supplies, or drugs for the18
diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury,19
or disease.20 HLS 14RS-161 ORIGINAL
HB NO. 601
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
(2) "Health insurance coverage" means benefits consisting of medical care1
provided or arranged for directly, through insurance or reimbursement, or otherwise,2
and includes healthcare services paid for under any plan, policy, or certificate of3
insurance.4
(3) "Health insurance issuer" means any entity that offers health insurance5
coverage through a policy or certificate of insurance subject to state law that6
regulates the business of insurance. For purposes of this Subpart, a "health insurance7
issuer" shall include a health maintenance organization, as defined and licensed8
pursuant to Subpart I of Part I of Chapter 2 of this Title, nonfederal government9
plans subject to the provisions of Subpart B of this Part, and the Office of Group10
Benefits.11
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Abramson HB No. 601
Abstract: Prohibits healthcare providers from refusing to submit a claim to an insurer
under certain circumstances.
Proposed law prohibits a provider of healthcare services from refusing to submit a claim to
the patient's insurer or refusing to provide treatment unless the patient agrees to pay the
claim in full should the patient's insurer deny payment for the claim.
Proposed law does not preclude a provider from requiring an insured to pay for healthcare
services directly to the provider if the claim is denied but the services are not yet provided
but still requested by the insured.
Proposed law defines terms "healthcare services", "health insurance coverage", and "health
insurance issuer".
(Adds R.S. 22:1827)