HLS 19RS-927 ORIGINAL
2019 Regular Session
HOUSE BILL NO. 352
BY REPRESENTATIVE DUBUISSON
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
INSURANCE: Authorizes health insurance issuers to establish modern healthcare costs and
quality programs
1 AN ACT
2To enact R.S. 22:1100 and R.S. 40:2203.1(H), relative to cost and quality programs for
3 health insurance issuers; to authorize health insurance issuers and health
4 maintenance organizations to establish healthcare cost and quality programs; to
5 authorize group purchasers and preferred provider organizations to establish modern
6 cost and quality programs; to establish an exception to prohibited acts by preferred
7 provider organizations; and to provide for related matters.
8Be it enacted by the Legislature of Louisiana:
9 Section 1. R.S. 22:1100 is hereby enacted to read as follows:
10 §1100. Modern healthcare cost and quality programs
11 A. Notwithstanding the provisions of R.S. 22:34 and R.S. 22:1964 or any
12 law to the contrary, a health insurance issuer or a health maintenance organization
13 may establish any of the following without regard to uniform availability or
14 applicability to all insureds or policyholders or healthcare providers:
15 (1) Quality programs.
16 (2) Disease management programs.
17 (3) Population health management programs.
18 (4) Pharmaceutical management programs.
19 (5) Partnerships or other shared risk programs with healthcare providers or
20 professional associations.
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HLS 19RS-927 ORIGINAL
HB NO. 352
1 (6) Other trial or pilot programs.
2 B. In addition to health insurance issuers and health maintenance
3 organizations, group purchasers and preferred provider organizations may establish
4 modern cost and quality programs as authorized pursuant to R.S. 40:2203 et seq.
5 Section 2. R.S. 40:2203.1(H) is hereby enacted to read as follows:
6 §2203.1. Prohibition of certain practices by preferred provider organizations;
7 exception
8 * * *
9 H. It shall not be a prohibited practice for health insurance issuers, health
10 maintenance organizations licensed pursuant to Title 22 of the Louisiana Revised
11 Statutes of 1950, group purchasers, or preferred provider organizations to establish
12 or enter into agreements to operate or maintain modern healthcare cost and quality
13 programs as authorized pursuant to R.S. 22:1100.
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)]
HB 352 Original 2019 Regular Session DuBuisson
Abstract: Authorizes health insurance issuers to establish healthcare cost and quality
programs.
Present law prohibits an insurer from making or permitting any unfair discrimination in
favor of particular individuals or persons, or between insureds or subjects of insurance
having substantially like insuring risk, and exposure factors, or expense elements, in the
terms or conditions of any insurance contract, or in the rate or amount of premium charged
therefor, or in the benefits payable or in any other rights or privileges accruing thereunder.
Proposed law retains present law but authorizes health insurance issuers, health maintenance
organizations, group purchasers, and preferred provider organizations to establish any of the
following without regard to uniform availability or applicability to all insureds or
policyholders or healthcare providers:
(1)Quality programs.
(2)Disease management programs.
(3)Population health management programs.
(4)Pharmaceutical management programs.
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HLS 19RS-927 ORIGINAL
HB NO. 352
(5)Partnerships or other shared risk programs with healthcare providers or professional
associations.
(6)Other trial or pilot programs.
Present law prohibits certain practices by preferred provider organizations.
Proposed law retains present law but authorizes health insurance issuers, health maintenance
organizations, group purchasers, and preferred provider organizations to establish or enter
into agreements to operate or maintain modern healthcare cost and quality programs.
(Adds R.S. 22:1100 and R.S. 40:2203.1(H))
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.