SLS 22RS-354 ENGROSSED
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 consider the treatment experimental
16 or outside of their policy scope if the United States Food and Drug
17 Administration has approved the drug for the treatment of cancer with the
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 ENGROSSED
1 specific genetic mutation, even if in a different tumor type. Such This coverage
2 may be denied only if an alternative treatment has proven to be more effective in
3 published randomized clinical trials and is not contraindicated in the patient.
4 * * *
The original instrument was prepared by Thomas L. Tyler. The following
digest, which does not constitute a part of the legislative instrument, was
prepared by Beth O'Quin.
DIGEST
SB 146 Engrossed 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 cannot consider the treatment experimental or
outside of their policy scope if the United States Food and Drug Administration has
approved the drug for the treatment of cancer with the specific genetic mutation, even if its
in a different tumor type. 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))
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Insurance to the original
bill
1. Makes technical changes.
2. Adds that an insurer cannot consider the treatment experimental or outside
their policy scope if the United States Food and Drug Administration has
approved the drug for cancer treatment with the specific genetic mutation,
even if in a different tumor type.
Page 2 of 2
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.