HLS 19RS-425 ORIGINAL
2019 Regular Session
HOUSE BILL NO. 370
BY REPRESENTATIVE STOKES
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
INSURANCE/HEALTH: Provides relative to prescription drug benefits for persons with
stage-four advanced, metastatic cancer
1 AN ACT
2To amend and reenact R.S. 22:1053(A) and (D) and to enact R.S. 22:1053(E), relative to
3 prescription drug benefits for persons with stage-four advanced, metastatic cancer;
4 to prohibit denial of a prescription based upon step therapy or fail first protocols; to
5 define key terms; to provide for an effective date; and to provide for related matters.
6Be it enacted by the Legislature of Louisiana:
7 Section 1. R.S. 22:1053(A) and (D) are hereby amended and reenacted and R.S.
822:1053(E) is enacted to read as follows:
9 ยง1053. Requirement for coverage of step therapy or fail first protocols
10 A. Notwithstanding the provisions of R.S. 22:1047 to the contrary, any Any
11 health care coverage plan specified in Subsection D E of this Section which includes
12 prescription benefits as part of its policy or contract, which utilizes step therapy or
13 fail first protocols, and which is issued for delivery, delivered, renewed, or otherwise
14 contracted for in this state on or after January 1, 2011, shall comply with the
15 provisions of this Section.
16 * * *
17 D. No health coverage plan shall use step therapy or fail first protocols as the
18 basis to restrict any prescription benefit for the treatment of stage-four advanced,
19 metastatic cancer or associated conditions if the prescribed drug is both of the
20 following:
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HLS 19RS-425 ORIGINAL
HB NO. 370
1 (1) Consistent with best practices for the treatment of stage-four advanced,
2 metastatic cancer or associated conditions.
3 (2) Supported by peer-reviewed, evidenced-based medical literature.
4 E.(1) As used in this Section, a "health coverage plan" shall mean any
5 hospital, health, or medical expense insurance policy, hospital or medical service
6 contract, employee welfare benefit plan, contract or agreement with a health
7 maintenance organization or a preferred provider organization, health and accident
8 insurance policy, or any other insurance contract of this type, including a group
9 insurance plan and the Office of Group Benefits programs.
10 (2) As used in this Section, "stage-four advanced, metastatic cancer" means
11 cancer that has spread from the lymph nodes or other areas or parts of the body.
12 Section 2. This Act shall become effective upon signature by the governor or, if not
13signed by the governor, upon expiration of the time for bills to become law without signature
14by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If
15vetoed by the governor and subsequently approved by the legislature, this Act shall become
16effective on the day following such approval.
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 370 Original 2019 Regular Session Stokes
Abstract: Prohibits a health insurer from using step therapy or fail first protocols as the
basis to restrict any prescription benefit for the treatment of a person with stage-four
advanced, metastatic cancer.
Present law requires any health coverage plan which includes prescription benefits as part
of its policy or contract, which utilizes step therapy or fail first protocols, and which is
issued for delivery, delivered, renewed, or otherwise contracted for in this state on or after
Jan. 1, 2011, to comply with the provisions of present law.
Proposed law retains present law but makes technical changes including the removal of a
reference to a repealed statute.
Proposed law prohibits a health coverage plan from using step therapy or fail first protocols
as the basis to restrict any prescription benefit for the treatment of stage-four advanced,
metastatic cancer or associated conditions if the prescribed drug is consistent with best
practices for the treatment of stage-four advanced, metastatic cancer or associated conditions
and supported by peer-reviewed, evidenced-based medical literature.
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CODING: Words in struck through type are deletions from existing law; words underscored
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HB NO. 370
Proposed law defines "stage-four advanced, metastatic cancer" as cancer that has spread
from the lymph nodes or other areas or parts of the body.
Effective upon signature of the governor or lapse of time for gubernatorial action.
(Amends R.S. 22:1053(A) and (D); Adds R.S. 22:1053(E))
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.