HLS 22RS-791 REENGROSSED
2022 Regular Session
HOUSE BILL NO. 459
BY REPRESENTATIVES CHARLES OWEN, AMEDEE, AND HORTON
HEALTH CARE: Enacts the Life-Sustaining Care Act
1 AN ACT
2To enact R.S. 22:1054.2 and Subpart A-1 of Part I of Subchapter A of Chapter 5-D of Title
3 40 of the Louisiana Revised Statutes of 1950, to be comprised of R.S. 40:1152.1
4 through 1152.6, relative to medical care and treatment; to enact certain requirements
5 for healthcare providers and institutions relative to life-sustaining procedures; to
6 provide relative to insurance coverage of such procedures; to provide for
7 construction; to provide a limitation of liability; to provide for definitions; and to
8 provide for related matters.
9Be it enacted by the Legislature of Louisiana:
10 Section 1. R.S. 22:1054.2 is hereby enacted to read as follows:
11 §1054.2. Requirement for access to coverage for life-sustaining procedures
12 A. No health coverage plan shall deny coverage for the provision or
13 continuation of a directed life-sustaining procedure or service provided in accordance
14 with the Life-Sustaining Care Act, R.S. 40:1152.1 et seq.
15 B. For purposes of this Section, "health coverage plan" means any hospital,
16 health, or medical expense insurance policy, hospital or medical service contract,
17 employee welfare benefit plan, contract, or other agreement with a health
18 maintenance organization or a preferred provider organization, health and accident
19 insurance policy, or any other insurance contract of this type in this state.
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1 Section 2. Subpart A-1 of Part I of Subchapter A of Chapter 5-D of Title 40 of the
2Louisiana Revised Statutes of 1950, comprised of R.S. 40:1152.1 through 1152.6, is hereby
3enacted to read as follows:
4 SUBPART A-1. THE LIFE-SUSTAINING CARE ACT
5 §1152.1. Short title
6 This Subpart shall be known and may be cited as the "Life-Sustaining Care
7 Act".
8 §1152.2. Legislative findings; purpose
9 The legislature hereby finds and declares that any patient whose desire for
10 life-sustaining care is refused by a healthcare provider would benefit from laws
11 providing for the continuance of life-sustaining care pending a transfer to a willing
12 provider or institution. The purpose of this Subpart is to ensure the continued
13 provision of healthcare procedures or services when a healthcare provider or
14 healthcare institution declines to honor a request by a patient, or a person who may
15 consent to medical treatment on behalf of the patient, for the provision or
16 continuation of life-sustaining care until a transfer can be effected, and to make
17 reasonable efforts to assist in the transfer of the patient to a willing provider or
18 institution.
19 §1152.3. Definitions
20 As used in this Subpart, the following terms have the meaning ascribed in this
21 Section:
22 (1) "Healthcare institution" means any public or private organization,
23 corporation, partnership, sole proprietorship, association, agency, network, joint
24 venture, or other entity that is involved in providing healthcare services, including
25 but not limited to hospitals, clinics, medical centers, ambulatory surgical centers,
26 private physician's offices, nursing homes, or other institutions or locations wherein
27 healthcare services are provided to any person.
28 (2) "Healthcare provider" means any individual who may be asked to
29 participate in any way in a healthcare service, including, but not limited to a
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1 physician, physician assistant, nurse, nurse aide, medical assistant, hospital
2 employee, clinic employee, nursing home employee, or any other person who
3 furnishes or assists in the furnishing of healthcare services.
4 (3) "Life-sustaining procedure" means any medical procedure or intervention
5 which, in reasonable medical judgment, has the possibility of sustaining the life of
6 the patient.
7 §1152.4. Provision of life-sustaining procedures
8 A. If a patient, an individual who has authority to consent on behalf of a
9 patient in accordance with R.S. 40:1159.4, or an advance directive of a patient
10 directs the provision or opposes the withdrawal of a life-sustaining procedure, a
11 healthcare provider or healthcare institution shall ensure the provision or
12 continuation of the directed life-sustaining procedure.
13 B.(1) A healthcare provider or healthcare institution that is unwilling to
14 provide a directed life-sustaining procedure pursuant to Subsection A of this Section
15 may transfer the patient to another healthcare provider or healthcare institution
16 capable of and willing to provide the procedure. Upon the identification of a capable
17 and willing healthcare provider or healthcare institution by the patient or an
18 individual who has authority to consent on behalf of the patient in accordance with
19 R.S. 40:1159.4, the unwilling healthcare provider or healthcare institution shall make
20 a reasonable and good faith attempt to transfer the patient to the willing healthcare
21 provider or healthcare institution identified by the patient or an individual who has
22 legal authority to consent on his behalf. However, the unwilling healthcare provider
23 or healthcare institution shall make a good faith effort to ensure the provision or
24 continuation of the directed life-sustaining procedure. Any transfer of a patient
25 pursuant to the provisions of this Subsection shall be conducted promptly upon
26 agreement by the receiving healthcare provider or healthcare institution to admit the
27 patient.
28 (2) If the patient, his advance directive, or an individual who has authority
29 to consent on his behalf in accordance with R.S. 40:1159.4 is in conflict with the
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1 healthcare provider or healthcare institution treating the patient regarding whether
2 life-sustaining care for the patient should be continued, the patient or individual who
3 has authority to consent on his behalf shall, within thirty days of that person and the
4 provider or institution mutually acknowledging the conflict, identify a healthcare
5 provider or healthcare institution that is capable of and willing to provide life-
6 sustaining care for the patient. If no willing provider or institution is identified and
7 the conflict remains unresolved after the expiration of the thirty-day period provided
8 for in this Paragraph, the provider or institution treating the patient shall pursue a
9 legal remedy in the district court of the judicial district in which it is located.
10 C. In any instance in which the services provided to a patient for the
11 provision or continuation of a directed life-sustaining procedure are not covered by
12 any public or private health insurance coverage, payment for the services provided
13 in accordance with this Subpart shall remain the obligation of the patient.
14 §1152.5. Advance directives and other declarations and orders not affected
15 Nothing in this Subpart shall be construed to supersede a properly signed and
16 executed living will, advance directive, declaration concerning life-sustaining
17 procedures, or physician order for scope of treatment form prepared in accordance
18 with Subpart A, B, or C of this Part or any other applicable provisions of law.
19 §1152.6. Limitation of liability
20 Compliance with this Subpart shall not create, or be construed or interpreted
21 to create, a new cause of action or to create a standard of care, obligation, or duty
22 that provides a basis for a cause of action.
23 Section 3. Any provision of this Act held to be invalid or unenforceable by its terms,
24or as applied to any person or circumstance, shall be construed so as to give it the maximum
25effect permitted by law, unless such holding is one of utter invalidity or unenforceability,
26in which event such provision shall be deemed severable in accordance with R.S. 24:175,
27and shall not affect the remainder hereof or the application of such provision to other persons
28not similarly situated or to other, dissimilar circumstances.
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HB NO. 459
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 459 Reengrossed 2022 Regular Session Charles Owen
Abstract: Enacts the Life-Sustaining Care Act which establishes a duty for healthcare
providers and institutions to provide life-sustaining care in certain instances.
Proposed law provides that its purpose is to ensure the continued provision of healthcare
procedures or services when a healthcare provider or healthcare institution declines to honor
a request by a patient, or a person who may consent to medical treatment on behalf of the
patient, for the provision or continuation of life-sustaining care until a transfer can be
effected, and to make reasonable efforts to assist in the transfer of the patient to a willing
provider or institution.
Proposed law defines "life-sustaining care" as any medical procedure or intervention which,
in reasonable medical judgment, has the possibility of sustaining the life of the patient.
Proposed law stipulates that if a patient, a person who may consent to medical treatment on
behalf of the patient in accordance with present law (R.S. 40:1159.4), or an advance
directive of a patient directs the provision or opposes the withdrawal of a life-sustaining
procedure, a healthcare provider or institution shall ensure the provision or continuation of
the directed life-sustaining care.
Proposed law authorizes healthcare providers and institutions that are unwilling to provide
a directed life-sustaining procedure to transfer the patient to another healthcare provider or
healthcare institution capable of and willing to provide the procedure. Provides for the
process by which such a transfer may be effected.
Proposed law provides that if the patient, his advance directive, or an individual who has
authority to consent on his behalf is in conflict with the healthcare provider or healthcare
institution treating the patient regarding whether life-sustaining care for the patient should
be continued, the patient or individual who has authority to consent on his behalf shall,
within 30 days of that person and the provider or institution mutually acknowledging the
conflict, identify a healthcare provider or healthcare institution that is capable of and willing
to provide life-sustaining care for the patient.
Proposed law requires that if no willing provider or institution is identified and the conflict
over life-sustaining care for the patient remains unresolved after the expiration of the 30-day
period afforded in proposed law, the provider or institution treating the patient shall pursue
a legal remedy in a court of law.
Proposed law stipulates that nothing therein shall be construed to supersede a properly
signed and executed living will, advance directive, declaration concerning life-sustaining
procedures, or physician order for scope of treatment form prepared in accordance with
applicable provisions of present law.
Proposed law provides that compliance with proposed law shall not create, or be construed
or interpreted to create, a new cause of action or to create a standard of care, obligation, or
duty that provides a basis for a cause of action.
Proposed law prohibits health coverage plans from denying coverage for the provision or
continuation of a directed life-sustaining procedure or service delivered in accordance with
proposed law. Provides that for purposes of proposed law, "health coverage plan" means
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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 this state.
Proposed law stipulates that when services provided to a patient for the provision or
continuation of a directed life-sustaining procedure are not covered by any public or private
health insurance coverage, payment for the services provided in accordance with proposed
law shall remain the obligation of the patient.
(Adds R.S. 22:1054.2 and R.S. 40:1152.1-1152.6)
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Health and Welfare to
the original bill:
1. Provide within the La. Insurance Code (Title 22 of present law) that no health
coverage plan shall deny coverage for the provision or continuation of a directed
life-sustaining procedure or service provided in accordance with proposed law.
2. Revise legislative findings and purpose language provided in proposed law.
3. Revise the definitions of "legal representative" and "life-sustaining procedure"
provided in proposed law.
4. Revise proposed law pertaining to transfer of patients in instances in which a
healthcare provider or healthcare institution is unwilling to provide a directed
life-sustaining procedure pursuant to proposed law.
5. Stipulate that when services provided to a patient for the provision or
continuation of a directed life-sustaining procedure are not covered by any public
or private health insurance coverage, payment for the services provided in
accordance with proposed law shall remain the obligation of the patient.
6. Stipulate that nothing in proposed law shall be construed to supersede a properly
signed and executed living will, advance directive, declaration concerning
life-sustaining procedures, or physician order for scope of treatment form
prepared in accordance with applicable provisions of present law.
7. Provide that compliance with proposed law shall not create, or be construed or
interpreted to create, a new cause of action or to create a standard of care,
obligation, or duty that provides a basis for a cause of action.
8. Make technical changes.
The House Floor Amendments to the engrossed bill:
1. Delete the defined term "legal representative" from proposed law and replace
instances of the term with references to "an individual who has authority to
consent on behalf of a patient" in accordance with present law relative to medical
consent (R.S. 40:1159.4).
2. Provide that if the patient, his advance directive, or an individual who has
authority to consent on his behalf is in conflict with the healthcare provider or
healthcare institution treating the patient regarding whether life-sustaining care
for the patient should be continued, the patient or individual who has authority
to consent on his behalf shall, within 30 days of that person and the provider or
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institution mutually acknowledging the conflict, identify a healthcare provider
or healthcare institution that is capable of and willing to provide life-sustaining
care for the patient.
3. Require that if no willing provider or institution is identified and the conflict over
life-sustaining care for the patient remains unresolved after the expiration of the
30 period, the provider or institution treating the patient shall pursue a legal
remedy in a court of law.
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