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)]
HR 149 Original 2015 Regular Session Robert Johnson
Urges and requests the Department of Insurance to study the appeals process and its impact on those
with critical illnesses and to report findings and recommendations to the House Committee on
Insurance on or before Jan. 15, 2016.
Specifies that the following factors be included in the study: how many adverse determinations, not
based on formulary changes, are made during one year in this state; how many appeals are filed
based on such adverse determinations; the average length of such an appeal; how many of these
appeals are upheld or overturned; the average notification time of the adverse decision; whether the
person's physician is consulted prior to making the adverse determination; and what factors are
considered when an adverse determination is made due to the health insurer finding a medication
medically unnecessary.