RDCSB146 3264 3670
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)]
SB 146 Engrossed 2022 Regular Session Talbot
Present law prohibits a health coverage plan from denying coverage for the treatment of
metastatic or unresectable tumors with a medically necessary drug prescribed by a physician
on the 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 U.S. Food and Drug Administration (FDA) 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 such treatment is not contraindicated in the patient. Proposed law retains the present law
prohibition but applies it to the treatment of other advanced cancers.
Proposed law prohibits denial of coverage on the basis that the medically necessary drug is
not indicated for a specific tumor type. Further prohibits an insurer from considering the
treatment as experimental or outside of its policy scope if the FDA has approved the drug
for the treatment of cancer with the specific genetic mutation, even if the treatment is for a
different type of tumor.
(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.
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Insurance to the
engrossed bill:
1. Change "may" to "shall" to reflect the intentions of proposed law.
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