SLS 20RS-512 ORIGINAL
2020 Regular Session
SENATE BILL NO. 204
BY SENATOR TALBOT
INSURANCE POLICIES. Provides for health insurance coverage of cancer treatments.
(gov sig)
1 AN ACT
2 To 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.
7 Be 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
10 genetic mutation
11 A. No health coverage plan delivered or issued for delivery in this state
12 shall deny coverage for a medically necessary drug prescribed by a physician
13 on the sole basis that the drug is not indicated for the location in the body of the
14 patient's cancer if the drug is approved by the United States Food and Drug
15 Administration for the treatment of the specific mutation of the patient's
16 cancer.
17 B.(1) Any health coverage plan delivered or issued for delivery in this
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 204
SLS 20RS-512 ORIGINAL
1 state shall include coverage for a minimum initial treatment period of not less
2 than three months for a medically necessary drug prescribed by a physician
3 that is not indicated for the location in the body of the patient's cancer if the
4 drug is approved by the United States Food and Drug Administration for the
5 treatment of the specific mutation of the patient's cancer.
6 (2) The health coverage plan shall continue to provide coverage of the
7 prescribed drug after the initial treatment period provided for in Paragraph (1)
8 of this Subsection if the treating physician certifies that the prescribed drug is
9 necessary for the treatment of the patient's cancer.
10 C. For purposes of this Section, "health coverage plan" means any
11 hospital, health, or medical expense insurance policy, hospital or medical
12 service contract, employee welfare benefit plan, contract, or other agreement
13 with a health maintenance organization or a preferred provider organization,
14 health and accident insurance policy, or any other insurance contract of this
15 type in this state, including a group insurance plan, a self-insurance plan, and
16 the Office of Group Benefits programs. "Health coverage plan" shall not
17 include a plan providing coverage for excepted benefits as defined in R.S.
18 22:1061, limited benefit health insurance plans, and short-term policies that
19 have a term of less than twelve months.
20 Section 2. This Act shall become effective upon signature by the governor or, if not
21 signed by the governor, upon expiration of the time for bills to become law without signature
22 by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If
23 vetoed by the governor and subsequently approved by the legislature, this Act shall become
24 effective on the day following such approval.
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Cheryl B. Cooper.
DIGEST
SB 204 Original 2020 Regular Session Talbot
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
Page 2 of 3
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 204
SLS 20RS-512 ORIGINAL
drug is approved by the United States Food and Drug Administration (FDA) for the
treatment of the specific mutation of the patient's cancer.
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 the governor or lapse of time for gubernatorial action.
(Adds R.S. 22:1054.1)
Page 3 of 3
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.