2022 Regular Session ENROLLED
SENATE BILL NO. 112
BY SENATOR ROBERT MILLS
1 AN ACT
2 To enact Subpart A-4 of Part III of Chapter 4 of Title 22 of the Louisiana Revised Statutes
3 of 1950, to be comprised of R.S. 22:1020.61, relative to health insurance; to provide
4 for prior authorization for health insurance claims related to certain healthcare
5 procedures; to provide for the creation of programs for the selective application of
6 prior authorization; to provide for definitions; to provide for development and
7 maintenance of programs seeking to reduce prior authorization requirements related
8 to certain healthcare services performed by certain healthcare providers; to provide
9 for the promulgation of rules; and to provide for related matters.
10 Be it enacted by the Legislature of Louisiana:
11 Section 1. Subpart A-4 of Part III of Chapter 4 of Title 22 of the Louisiana Revised
12 Statutes of 1950, comprised of R.S. 22:1020.61, is hereby enacted to read as follows:
13 SUBPART A-4. REDUCING ADMINISTRATIVE BURDENS
14 IN HEALTH INSURANCE
15 ยง1020.61. Selective application of prior authorization
16 A.(1) Every health insurance issuer authorized to do business in this state
17 shall implement and maintain a program that allows for the selective
18 application of reducing prior authorization requirements that are based on the
19 stratification of healthcare providers' performance and adherence to
20 evidence-based medicine. The program shall promote quality, affordable health
21 care, and reduce unnecessary administrative burdens for both the health
22 insurance issuer and the healthcare provider. Criteria for participation by
23 healthcare providers and the healthcare services included in the program
24 excluding pharmacy services shall be at the sole discretion of the health
25 insurance issuer. A health insurance issuer shall submit to the Louisiana
ACT No. 432
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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. 112 ENROLLED
1 Department of Insurance a filing, in accordance with Subsection B of this
2 Section, concerning the program that includes a full narrative description, the
3 criteria for participation, a listing of the procedures and services subject to
4 selective application of prior authorization, and the number of healthcare
5 providers participating in the program.
6 (2) For the purposes of this Section, "health insurance issuer" has the
7 same meaning as provided for in R.S. 22:1019.1.
8 B. The filing shall be in a form and manner provided for by the
9 Louisiana Department of Insurance, promulgated in accordance with the
10 Administrative Procedure Act, and shall be submitted initially by July 1, 2023,
11 and each time the health insurance issuer makes a filing in accordance with R.S.
12 22:571 thereafter.
13 Section 2. This Act shall become effective upon signature by the governor or, if not
14 signed by the governor, upon expiration of the time for bills to become law without signature
15 by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If
16 vetoed by the governor and subsequently approved by the legislature, this Act shall become
17 effective on the day following such approval.
PRESIDENT OF THE SENATE
SPEAKER OF THE HOUSE OF REPRESENTATIVES
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED:
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.