SLS 18RS-676 ORIGINAL
2018 Regular Session
SENATE BILL NO. 285
BY SENATOR GARY SMITH
HEALTH/ACC INSURANCE. Prohibits a health insurance issuer from denying a nonopioid
prescription in favor of an opioid prescription. (8/1/18)
1 AN ACT
2 To enact R.S. 22:1060.7, relative to prescriptions for chronic pain; to prohibit the denial of
3 coverage for a nonopioid prescription in favor of an opioid prescription; to provide
4 with respect to opioid prescriptions deemed medically necessary and prescribed by
5 a licensed physician; and to provide for related matters.
6 Be it enacted by the Legislature of Louisiana:
7 Section 1. R.S. 22:1060.7 is hereby enacted to read as follows:
8 ยง1060.7. Prescription medication for chronic pain
9 A. Notwithstanding any provision of law to the contrary, when a
10 licensed physician prescribes a nonopioid medication for the treatment of
11 chronic pain, it shall be unlawful for a health insurance issuer to deny coverage
12 of the nonopioid prescription drug in favor of an opioid prescription drug.
13 B. When an opioid prescription is deemed medically necessary and
14 prescribed by a licensed physician, it shall be unlawful for an insurer to deny
15 a prescribed medication and attempt to substitute an alternative medication
16 that requires any of the following:
17 (1) An increased number of pills per prescription.
Page 1 of 2
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 285
SLS 18RS-676 ORIGINAL
1 (2) A higher Drug Enforcement Administration schedule medication
2 than the one prescribed.
3 (3) The substitution of a mediation that does not have defined abuse
4 deterrent properties for a prescription of a medication that does have defined
5 abuse deterrent properties.
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Cheryl Cooper.
DIGEST
SB 285 Original 2018 Regular Session Gary Smith
Present law defines "health insurance issuer" as an entity that offers a health benefit plan
through a policy, contract, or certificate of insurance subject to state law that regulates the
business of insurance.
Present law defines "prescription drug" as:
(1)A substance for which federal or state law requires a prescription before the
substance may be legally dispensed to the public.
(2)A drug or device that under federal law is required, before being dispensed or
delivered, to be labeled with the statement: "Caution: Federal law prohibits
dispensing without prescription" or "Rx only" or another legend that complies with
federal law.
(3)A drug or device that is required by federal or state statute or regulation to be
dispensed on prescriptions or that is restricted to use by a physician or other
authorized prescriber.
Proposed law prohibits a health insurance issuer from denying coverage of a non-opioid
prescription drug in favor of an opioid prescription drug.
Proposed law provides when opioids are deemed medically necessary by a licensed
physician, it shall be unlawful for an insurer to deny a physician prescribed medication and
recommend an alternative prescription which requires any of the following:
(1)An increased number of pills per prescription.
(2)A higher Drug Enforcement Administration schedule medication than the one
prescribed.
(3)The substitution of a medication that does not have defined abuse deterrent
properties for a prescription of a mediation that does have defined abuse deterrent
properties.
Effective August 1, 2018.
(Adds R.S. 22:1060.7)
Page 2 of 2
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.