SSHB392 4300 4798
HOUSE SUMMARY OF SENATE AMENDMENTS
HB 392 2024 Regular Session Freeman
MEDICAID: Provides relative to Medicaid and private insurance coverage for
perimenopausal and menopausal care
Synopsis of Senate Amendments
1.Requires health insurance issuers that offer health coverage plans in this state
to provide coverage for any medically necessary care or treatment for
menopause and perimenopause.
2.Prohibits health insurance issuers from requiring prior authorization or
otherwise being subject to a step-therapy or fail-first policy or protocol for the
administration or prescription of any medication administered or prescribed for
hormone replacement therapy used to treat symptoms of menopause and
perimenopause.
3.Removes proposed law provision that requires health insurance issuers in this
state that provide hospital, medical, or surgical benefits for insured individuals
to provide coverage for expenses incurred for medically necessary
perimenopausal and menopausal care or treatment.
4.Makes technical corrections.
Digest of Bill as Finally Passed by Senate
Proposed law requires a health insurance issuer offering health coverage plans in this state
to provide coverage for any medically necessary care or treatment for menopause and
perimenopause.
Proposed law prohibits health insurance issuers from requiring prior authorization or
otherwise being subject to a step-therapy or fail-first policy or protocol for the administration
or prescription of any medication administered or prescribed for hormone replacement
therapy used to treat symptoms of menopause and perimenopause.
Proposed law requires La. Dept. of Health (LDH) to make available to persons who are
eligible for Medicaid benefits under present law coverage benefits for hormonal menopausal
care for any woman who is experiencing menopausal or perimenopausal symptoms.
Proposed law defines "perimenopausal" and "menopause".
Proposed law provides that symptoms for which such funding shall be made available
include but are not limited to the following:
(1) Irregular menstrual periods.
(2) Hot flashes.
(3) Vaginal or bladder problems.
(4) Decrease in fertility.
(5) Loss of bone.
Page 1 of 2 SSHB392 4300 4798
(6) Increase in low-density lipoprotein cholesterol levels.
(7) Sleep disruption, which includes night sweats.
Proposed law provides that LDH may seek approval of a federal Medicaid waiver and state
plan amendments as may be necessary to implement the provisions of this proposed law.
Proposed law requires the Medicaid program in this state to cover inpatient and, if deemed
appropriate, outpatient coverage for perimenopausal or menopausal treatment or care when
such care or treatment, is used for a medically accepted indication, and administered in any
healthcare facility by any healthcare professional appropriately licensed in this state to
provide such medical treatment or care in accordance with state and federal provisions.
Proposed law provides that the eligibility of a prospective enrollee shall be determined by
the healthcare facility appropriately providing perimenopausal or menopausal treatment or
care as provided in proposed law.
Proposed law establishes certain requirements for the secretary of LDH in compliance with
proposed law.
(Adds R.S. 22:988 and R.S. 40:1259.1 and 1259.2)
Page 2 of 2