SLS 22RS-354 ORIGINAL 2022 Regular Session SENATE BILL NO. 146 BY SENATOR TALBOT HEALTH/ACC INSURANCE. Provides for health insurance coverage of cancer treatments. (8/1/22) 1 AN ACT 2 To amend and reenact R.S. 22:1054.1(A), relative to insurance coverage for cancer 3 treatments; to prohibit denial of coverage in certain circumstances; and to provide 4 for related matters. 5 Be it enacted by the Legislature of Louisiana: 6 Section 1. R.S. 22:1054.1(A) is hereby amended and reenacted to read as follows: 7 ยง1054.1. Requirement for coverage of cancer treatment targeting a specific genetic 8 mutation 9 A. No health coverage plan delivered or issued for delivery in this state shall 10 deny coverage for the treatment of metastatic or unresectable tumors or other 11 advanced cancers with a medically necessary drug prescribed by a physician on the 12 sole basis that the drug is not indicated for the specific tumor type or location in the 13 body of the patient's cancer if the drug is approved by the United States Food and 14 Drug Administration for the treatment of the specific mutation of the patient's in a 15 different type of cancer. Insurers may not deem the treatment experimental or 16 outside of their policy scope. Such This coverage may be denied only if an 17 alternative treatment has proven to be more effective in published randomized Page 1 of 2 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 146 SLS 22RS-354 ORIGINAL 1 clinical trials and is not contraindicated in the patient. 2 * * * The original instrument and the following digest, which constitutes no part of the legislative instrument, were prepared by Thomas L. Tyler. DIGEST SB 146 Original 2022 Regular Session Talbot Present law prohibits denial of health insurance coverage for the treatment of metastatic or unresectable tumors with 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 Food and Drug Administration for the treatment of the specific mutation of the patient's cancer. Provides that coverage may be denied if an alternative treatment has proven to be more effective in published randomized clinical trials and is not contraindicated in the patient. Proposed law retains the present prohibition but applies it to the treatment of other advanced cancers and that the prohibition cannot be the basis that the drug is not indicated for the specific tumor type. Provides that the insurer many not deem the treatment experimental or outside of their policy scope. Provides that coverage may only be denied if an alternative treatment has proven to be more effective in published randomized clinical trials and is not contraindicated in the patient. Effective on August 1, 2022. (Amends R.S. 22:1054.1(A)) Page 2 of 2 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions.