The original instrument and the following digest, which constitutes no part of the
legislative instrument, were prepared by Beth O'Quin.
DIGEST
SB 104 Original 2023 Regular Session Stine
Proposed law requires any health coverage plan renewed, delivered, or issued for delivery, in this
state to include coverage for biomarker testing for the purpose of diagnosis, treatment, appropriate
management, or ongoing monitoring of an individual's disease or condition when the test is
supported by medical and scientific evidence, including any one of the following:
(1) Labeled indications for tests approved or cleared by the United States Food and Drug
Administration (FDA) or indicated tests for a drug approved by the FDA.
(2) Warnings and precautions listed on a FDA approved drug label.
(3) A Centers for Medicare and Medicaid Services National Coverage Determination or a
Medicare Administrative Contractor Local Coverage Determination.
(4) Nationally recognized clinical practice guidelines and consensus statements.
Proposed law authorizes the coverage is subject to annual deductibles, coinsurance, and copayment
provisions as are consistent with those established under the health plan.
Proposed law requires individuals and health care providers have access to clear, readily accessible,
convenient processes to request exceptions to a coverage policy or adverse determination review
determination of a health coverage plan. Requires the process to be included on a health coverage
plan's website.
Proposed law requires a health coverage plan to ensure coverage under proposed law is provided in
a manner that limits disruptions in care, including the need for multiple biopsies or biospecimen
samples.
Proposed law defines biomarker, biomarker testing, consensus statements, health coverage plans,
and Nationally recognized clinical practice guidelines.
Effective August 1, 2023.
(Adds R.S. 22:1028.5)