SLS 21RS-173 ENGROSSED
2021 Regular Session
SENATE BILL NO. 84
BY SENATOR TALBOT
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
INSURANCE POLICIES. Provides for health insurance coverage of genetic testing for
various cancer mutations. (1/1/22)
1 AN ACT
2 To enact R.S. 22:1028.3, relative to health insurance coverage; to require health insurance
3 coverage for genetic testing for various cancer mutations; to provide for the
4 definition of health coverage plan; to provide for definitions; and to provide for
5 related matters.
6 Be it enacted by the Legislature of Louisiana:
7 Section 1. R.S. 22:1028.3 is hereby enacted to read as follows:
8 ยง1028.3. Required coverage for genetic testing for cancer
9 A. The legislature hereby finds that cancer is a leading cause of death in
10 this state. Medical advances in genetic testing for various types of cancer
11 including but not limited to breast, ovarian, colon, thyroid, prostate, pancreatic,
12 lung, melanoma, sarcoma, kidney, and stomach cancers greatly assist in
13 estimating the chance of developing cancer in an individual's lifetime. Genetic
14 testing can help predict the risk of a particular cancer and assist in determining
15 if a patient has genes that may pass increased cancer risks to their children.
16 B.(1) Any health coverage plan renewed, delivered, or issued for delivery
17 in this state shall include coverage for genetic or molecular testing for cancer
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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. 84
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1 including but not limited to tumor mutation testing, next generation sequencing,
2 hereditary germline mutation testing, pharmacogenomic testing, whole exome
3 and genome sequencing, and biomarker testing.
4 (2) The coverage provided in this Section may be subject to annual
5 deductibles, coinsurance, and copayment provisions as are consistent with those
6 established under the health coverage plan. The coverage provided under this
7 Section may be subject to applicable evidence-based medical necessity criteria
8 under the plan.
9 C. For purposes of this Section, "health coverage plan" means any
10 hospital, health, or medical expense insurance policy, hospital or medical
11 service contract, employee welfare benefit plan, contract, or other agreement
12 with a health maintenance organization or a preferred provider organization,
13 health and accident insurance policy, or any other insurance contract of this
14 type in this state, including group insurance plan, a self-insurance plan, and the
15 office of group benefits programs. "Health coverage plan" shall not include a
16 plan providing coverage for excepted benefits defined in R.S. 22:1061, limited
17 benefit health insurance plans, and short-term policies that have a term of less
18 than twelve months.
19 D. As used in this Section, the following definitions shall apply unless the
20 context indicates otherwise:
21 (1) "Biomarker" means a characteristic that is objectively measured and
22 evaluated as an indicator of normal biological processes, pathogenic processes,
23 or pharmacologic responses to a specific therapeutic intervention. Biomarkers
24 include but are not limited to gene mutations or protein expression.
25 (2) "Biomarker testing" is the analysis of a patient's tissue, blood, or
26 fluid biospecimen for the presences of a biomarker. Biomarker testing includes
27 but is not limited to single-analyte tests, multi-plex panel tests, and partial or
28 whole genome sequencing.
29 Section 2. This Act shall become effective on January 1, 2022 and shall apply to any
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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. 84
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1 health coverage plan as defined in this Act that is renewed, delivered, or issued for delivery,
2 in this state on or after January 1, 2022.
The original instrument was prepared by Cheryl Cooper. The following
digest, which does not constitute a part of the legislative instrument, was
prepared by Thomas L. Tyler.
DIGEST
SB 84 Engrossed 2021 Regular Session Talbot
Proposed law requires any health coverage plan renewed, delivered, or issued for delivery,
in this state to include coverage for genetic or molecular cancer testing including but not
limited to tumor mutation testing, next generation sequencing, hereditary germline mutation
testing, pharmacogenomic testing, whole exome, genome sequencing and biomarker testing.
Provides that coverage may be subject to annual deductibles, coinsurance, copayment
provisions consistent with that established under the health coverage plan and that this
coverage may be subject to applicable evidence-based medical necessity criteria under the
health plan.
Proposed law defines health coverage plan as any hospital, health, or medical expense
insurance policy, hospital or medical service contract, employee welfare benefit plan,
contract, or other agreement with a health maintenance organization or a preferred provider
organization, health and accident insurance policy, or any other insurance contract of this
type in the state, including group insurance plans, self-insurance plans, and the office of
group benefits programs. Excludes a plan providing coverage for excepted benefits in
present law, limited benefit health insurance plans, and short-term policies that have a term
of less than 12 months.
Proposed law defines a biomarker and biomarker testing.
Proposed law applies to health coverage plans renewed, delivered, or issued for delivery in
their state on or after January 1, 2022.
Effective January 1, 2022.
(Adds R.S. 22:1028.3)
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Insurance to the original
bill
1. Removes provisions that the health plan include coverage for the cost of
genetic or molecular testing.
2. Adds biomarker testing to provisions regarding genetic or molecular testing
for cancer.
3. Provides that coverage may be subject to applicable evidence-based medical
necessity criteria.
4. Defines "biomarker" and ""biomarker testing".
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.