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)]
HB 435 Original 2023 Regular Session Freeman
Abstract: Provides Medicaid coverage for chimeric antigen receptor (CAR) T-cell therapy.
Proposed law defines "chimeric antigen receptor (CAR) T-cell therapy" and provides the definition
of "healthcare facility" as provided in present law.
Proposed law requires the Louisiana Medicaid program to provide inpatient and, if appropriate,
outpatient coverage for CAR T-cell therapy when such therapy has been approved by the U.S. Food
and Drug Administration, is used for a medically accepted indication, and is administered in a
healthcare facility appropriately providing CAR T-cell therapy in accordance with state and federal
guidelines or certifications.
Proposed law requires a healthcare facility appropriately providing CAR T-cell therapy in accordance
with state and federal guidelines or certifications to participate in the Louisiana Medicaid program
to provide CAR T-cell therapy to eligible enrollees, as defined in proposed law.
Proposed law requires a healthcare facility appropriately providing CAR T-cell therapy in accordance
with state and federal guidelines or certifications to make a determination of a prospective enrollee's
eligibility for CAR T-cell therapy enrollment.
Proposed law establishes the following requirements for a prospective enrollee to be considered
eligible for CAR T-cell therapy enrollment:
(1) The individual is enrolled in the Louisiana Medicaid program.
(2)A licensed healthcare provider has certified that CAR T-cell therapy is medically necessary
and appropriate to treat the individual's condition.
(3)The CAR T-cell therapy is administered in a healthcare facility appropriately providing CAR
T-cell therapy in accordance with state and federal guidelines or certifications.
Proposed law requires the secretary of the La. Dept. of Health to do the following:
(1) Submit to the Centers for Medicare and Medicaid Services all necessary state plan
amendments.
(2) Promulgate all necessary rules and regulations in accordance with present law. (3)Promulgate rules as necessary to regulate high cost pharmaceutical carve-outs.
(4)Take any other actions necessary to implement the provisions of proposed law.
(Adds R.S. 40:1258.1 and 1258.2)