HASBSB154 TYLERT 4012
SENATE SUMMARY OF HOUSE AMENDMENTS
SB 154 2022 Regular Session Talbot
KEYWORD AND SUMMARY AS RETURNED TO THE SENATE
HEALTH/ACC INSURANCE. Provides for health insurance coverage of genetic
testing for critically ill infants with no diagnosis. (1/1/23)
SUMMARY OF HOUSE AMENDMENTS TO THE SENATE BILL
1. Makes technical changes.
DIGEST OF THE SENATE BILL AS RETURNED TO THE SENATE
DIGEST
SB 154 Reengrossed 2022 Regular Session Talbot
Proposed law requires any health coverage plan renewed, delivered, or issued for delivery
in this state to include coverage for using advanced molecular techniques including but not
limited to traditional whole genome sequencing, rapid whole genome sequencing, and other
genetic and genomic screening that helps a physician timely diagnosis and guide treatment
for a critically ill infant who is 1 year or younger, receiving care in an intensive care unit or
pediatric care unit, and has a complex illness of unknown etiology.
Proposed law provides that coverage may be subject to annual deductibles, coinsurance, and
copayment provisions consistent with that established under the health coverage plan and
such coverage may be subject to applicable evidence-based medical necessity criteria based
on all of the following:
(1)The infant is suspected of having a rare genetic condition not diagnosable by a
standard clinical work-up.
(2)The infant has symptoms that suggest a broad differential diagnosis that requires an
evaluation by multiple genetic tests if advanced molecular techniques provided for
in proposed law are not performed.
(3)Timely identification of a molecular diagnosis is necessary in order to guide clinical
decision making and advanced molecular techniques provided for in proposed law
would guide the treatment or management of the infant's condition.
(4)The infant has at least 1 of the following conditions:
(a)Multiple congenital anomalies.
(b)Specific malformations highly suggestive of a genetic etiology.
(c)Abnormal laboratory tests suggesting the presence of a genetic disease or
complex metabolic phenotype like but not limited to an abnormal newborn
screen, hyperarammonemia, or lactic acidosis not due to poor perfusion.
(d)Refractory or severe hypoglycemia.
(e)Abnormal response to therapy related to an underlying medical condition that
affects vital organs or bodily systems.
(f)Severe hypotonia.
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(g)Refractory seizures.
(h)A high-risk stratification on evaluation for a brief resolved unexplained event
with any of the following:
(i)A recurrent event without respiratory infection.
(ii)A recurrent event witnessed seizure-like event.
(iii)A recurrent cardiopulmonary resuscitation.
(i)Abnormal chemistry levels including but not limited to electrolytes,
bicarbonate, lactic acid, venous blood gas, and glucose that suggests inborn
error of metabolism.
(j)Abnormal cardiac diagnostic test results suggesting possible channelopathies,
arrhythmias, cardiomyopathies, myocarditis, or structural heart disease.
(k)Family genetic history that relates to the infant's condition.
Proposed law defines "health coverage plan".
Proposed law applies to health coverage plans renewed, delivered, or issued for delivery in
this state on or after Jan. 1, 2023.
Effective Jan. 1, 2023.
(Adds R.S. 22:1028.4)
______________________
Thomas L. Tyler
Senate Counsel
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