The original instrument and the following digest, which constitutes no part of the
legislative instrument, were prepared by Cheryl Cooper.
DIGEST
SB 181 Original 2016 Regular Session Long
Present law provides for the purpose, scope, and definitions relative to the Network Adequacy Act.
Proposed law provides that rural hospital has the same meaning as in present law Rural Hospital
Preservation Act.
Present law prohibits the commissioner from acting to arbitrate, mediate, or settle disputes regarding
a decision not to include a health care provider in a health benefit plan or provider network.
Proposed law retains present law and adds that in the event a formal complaint is filed with the
commissioner by a rural hospital regarding a health insurance issuer's decision to exclude or not to
include a physician credentialed on the medical staff of a rural hospital in a health benefit plan or
provider network, the commissioner shall conduct an independent review to determine whether the
health insurance issuer's decision complies with the provisions of present law.
Proposed law requires the commissioner to notify a health insurance issuer in writing in the event
he determines the requirements of network adequacy have not been met. Further provides 30 days
for a health insurance issuer to voluntarily comply with the directives of the commissioner to cure
the network deficiency. Provides that failure to comply shall result in the penalty provisions in
present law.
Effective August 1, 2016.
(Amends R.S. 22:1019.2(A) and 1019.3(B); adds R.S. 22:1019.1(D)(21))