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.