HLS 20RS-651 ORIGINAL
2020 Regular Session
HOUSE BILL NO. 408
BY REPRESENTATIVE LACOMBE
INSURANCE/HEALTH: Provides for health insurance coverage of cancer treatments
1 AN ACT
2To enact R.S. 22:1054.1, relative to health insurance coverage for cancer treatments; to
3 prohibit denial of coverage in certain circumstances; to require coverage of
4 prescription drugs that target a specific mutation for a minimum initial period; to
5 require a physician's certification for continued coverage; to provide for an effective
6 date; and to provide for related matters.
7Be it enacted by the Legislature of Louisiana:
8 Section 1. R.S. 22:1054.1 is hereby enacted to read as follows:
9 ยง1054.1. Requirement for coverage of cancer treatment targeting a specific genetic
10 mutation
11 A. No health coverage plan delivered or issued for delivery in this state shall
12 deny coverage for a medically necessary drug prescribed by a physician on the sole
13 basis that the drug is not indicated for the location in the body of the patient's cancer
14 if the drug is approved by the United States Food and Drug Administration for the
15 treatment of the specific mutation of the patient's cancer.
16 B.(1) Any health coverage plan delivered or issued for delivery in this state
17 shall include coverage for a minimum initial treatment period of not less than three
18 months for a medically necessary drug prescribed by a physician that is not indicated
19 for the location in the body of the patient's cancer if the drug is approved by the
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HLS 20RS-651 ORIGINAL
HB NO. 408
1 United States Food and Drug Administration for the treatment of the specific
2 mutation of the patient's cancer.
3 (2) The health coverage plan shall continue to provide coverage of the
4 prescribed drug after the initial treatment period provided for in Paragraph (1) of this
5 Subsection if the treating physician certifies that the prescribed drug is necessary for
6 the treatment of the patient's cancer.
7 C. For purposes of this Section, "health coverage plan" means any hospital,
8 health, or medical expense insurance policy, hospital or medical service contract,
9 employee welfare benefit plan, contract, or other agreement with a health
10 maintenance organization or a preferred provider organization, health and accident
11 insurance policy, or any other insurance contract of this type in this state, including
12 a group insurance plan, a self-insurance plan, and the Office of Group Benefits
13 programs. "Health coverage plan" shall not include a plan providing coverage for
14 excepted benefits as defined in R.S. 22:1061, limited benefit health insurance plans,
15 and short-term policies that have a term of less than twelve months.
16 Section 2. This Act shall become effective upon signature by the governor or, if not
17signed by the governor, upon expiration of the time for bills to become law without signature
18by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If
19vetoed by the governor and subsequently approved by the legislature, this Act shall become
20effective 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 408 Original 2020 Regular Session LaCombe
Abstract: Requires insurance coverage for a drug that is not indicated for the bodily
location of a patient's cancer if the drug is approved by the FDA for the treatment of
the specific mutation of the patient's cancer.
Proposed law prohibits a health coverage plan delivered or issued for delivery in this state
from denying coverage for a medically necessary drug prescribed by a physician on the sole
basis that the drug is not indicated for the location in the body of the patient's cancer if the
drug is approved by the United States Food and Drug Administration (FDA) for the
treatment of the specific mutation of the patient's cancer.
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HLS 20RS-651 ORIGINAL
HB NO. 408
Proposed law requires any health coverage plan delivered or issued for delivery in this state
to include coverage for a minimum initial treatment period of at least three months for a
medically necessary drug prescribed by a physician that is not indicated for the location in
the body of the patient's cancer if the drug is approved by the FDA for the treatment of the
specific mutation of the patient's cancer.
Proposed law requires the health coverage plan to continue to provide coverage of the
prescribed drug after the initial treatment period if the treating physician certifies that the
prescribed drug is necessary for the treatment of the patient's cancer.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Adds R.S. 22:1054.1)
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.