HLS 24RS-716 REENGROSSED
2024 Regular Session
HOUSE BILL NO. 616
BY REPRESENTATIVE GREEN
INSURANCE/HEALTH: Provides relative to actuarial reviews of healthcare legislation
1 AN ACT
2To enact Part VIII of Chapter 11 of Title 22 of the Louisiana Revised Statutes of 1950, to
3 be comprised of R.S. 22:2188, and to repeal Part VIII of Chapter 11 of Title 22 of
4 the Louisiana Revised Statutes of 1950, comprised of R.S. 22:2187, relative to
5 actuarial reviews of healthcare legislation; to require the Department of Insurance
6 to contract with entities to perform actuarial reviews; to require relative to public
7 meetings; to provide relative to legislators' requests for actuarial reviews; to outline
8 intended outcomes; to provide relative to the commissioner of administration; to
9 provide for certain appropriations; to provide with respect to the confidentiality of
10 certain information; to repeal the Louisiana Mandated Health Benefits Commission;
11 and to provide for related matters.
12Be it enacted by the Legislature of Louisiana:
13 Section 1. Part VIII of Chapter 11 of Title 22 of the Louisiana Revised Statutes of
141950, comprised of R.S. 22:2188, is hereby enacted to read as follows:
15 PART VIII. LOUISIANA MANDATED HEAL TH ACTUARIAL ANALYSIS
16 ยง2188. Actuarial reviews of proposed healthcare legislation
17 A. On or before December first, the department shall retain by contract one
18 or more entities that have experience in actuarial reviews and healthcare policy for
19 the purpose of performing actuarial reviews of legislative proposals that may impose
20 a new health benefit coverage mandate on health benefit plans or reduce or eliminate
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1 coverage mandated under health benefit plans. At least one of the contracted entities
2 shall be an actuary or actuarial firm or a Louisiana-based university department or
3 academic faculty with experience analyzing health insurance premiums. The
4 department shall ensure that contractors are independent and free from conflicts of
5 interest that might affect the neutrality of the actuarial reviews. The contractors,
6 under the direction of the department, shall conduct actuarial reviews of legislative
7 proposals.
8 B. On or before September first, the department shall convene a public
9 meeting to obtain input and recommendations from stakeholders concerning the
10 methodology for conducting the analysis described in Subsection D of this Section.
11 C. A member of the legislature who requests an actuarial review of a
12 legislative proposal shall submit the request to the department no later than
13 December first of the year preceding the regular session of the legislature in which
14 the legislative proposal will be proposed.
15 D. A contractor shall consider in its actuarial review the predicted effects of
16 the legislative proposal during the five years immediately following the effective
17 date of the legislative proposal, or during another time period following the effective
18 date of the legislative proposal if such consideration is more actuarially feasible,
19 including all of the following:
20 (1) An estimate of the number of state residents who will be directly affected
21 by the legislative proposal.
22 (2) Estimates of changes in the rates of utilization of specific healthcare
23 services that may result from the legislative proposal.
24 (3) Estimates concerning any changes in consumer cost sharing that would
25 result from the legislative proposal.
26 (4) Estimates of any increases or decreases in premiums charged to covered
27 persons or employers for health benefit plans offered in the individual, small group,
28 and large group markets that would result from the legislative proposal.
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1 (5) An estimate of the out-of-pocket healthcare cost changes associated with
2 the legislative proposal.
3 (6) An estimate of the potential long-term healthcare cost changes associated
4 with the legislative proposal.
5 (7)(a) An estimate of the amounts necessary to defray the cost of the mandate
6 for health insurance products subject to state or federal laws requiring payments to
7 defray such costs, including an evaluation of whether the legislative proposal
8 includes a mandate requiring defrayal of costs.
9 (b) The department may seek the evaluation described in this Paragraph prior
10 to requesting the remaining actuarial review required by this Section.
11 (8) Identification of any potential health benefits for individuals or
12 communities that would result from the legislative proposal.
13 (9) To the extent practicable, the social and economic impacts of the
14 legislative proposal.
15 E. Contractors shall provide all of the following in the report of an actuarial
16 review performed pursuant to this Section:
17 (1) Information described in Paragraph (D)(4) of this Section in terms of
18 percentage increase or decrease and in terms of per-member, per-month charges.
19 (2) Information described in Paragraph (D)(5) of this Section in terms of
20 dollar amounts.
21 (3) Information described in Paragraph (D)(7) of this Section in terms of
22 per-member, per-month costs and monthly enrollment estimates by a health benefit
23 plan.
24 (4) If available, information concerning who would benefit from any cost
25 changes and health benefits from the legislative proposal, as identified in Paragraphs
26 (D)(3) through (D)(8) of this Section, and any disproportionate effects that the
27 legislative proposal would have on state residents, which information, if available,
28 shall be disaggregated, at a minimum, by race, ethnicity, sex, gender, and age.
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1 (5) To the extent practicable, a qualitative analysis of the impact of the
2 legislative proposal. For purposes of this Paragraph, a member of the legislature
3 who requests an actuarial review of a legislative proposal pursuant to this Section
4 may designate one or more persons to provide data to the contractors in order to
5 inform this qualitative analysis.
6 F. In performing actuarial reviews of legislative proposals, the contractors
7 may utilize data from any reasonable source, including data collected from insurers.
8 Insurers shall provide information to, and otherwise cooperate with, the contractors
9 and the department for purposes of this Section.
10 G. A request for an actuarial review pursuant to this Section and the final
11 report resulting from such a request shall be treated as confidential, except by the
12 member of the legislature or the chairmen of the House Committee on Insurance and
13 Senate Committee on Insurance, until the legislative proposal that is the subject of
14 the actuarial review is introduced in the regular legislative session following
15 submission of the request for the actuarial review or, if no such legislative proposal
16 is introduced, until after the end of the legislative session following the submission
17 of the request.
18 H. Upon enactment of any legislative proposal for which a defrayal cost has
19 been estimated pursuant to Paragraph (D)(7) of this Section, the department shall
20 notify, in writing, the commissioner of administration and the chairmen of the House
21 Committee on Appropriations and the Senate Committee on Finance of the estimated
22 cost. Upon receipt of the written notification, the commissioner of administration
23 shall request an appropriation to pay the estimated defrayal cost of each enacted
24 legislative proposal prior to implementation in the subsequent plan year.
25 I. Each year following initial implementation, the department shall require
26 insurers to provide actuarial estimates, based on appropriate claims and other data,
27 of the per-member, per-month amount necessary to defray the cost of the enacted
28 mandate for the subsequent plan year. After determining these estimates to be
29 actuarially sound, the department shall notify the commissioner of administration
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1 and the chairmen of the House Committee on Appropriations and the Senate
2 Committee on Finance of the amounts needed to defray the cost of the enacted
3 mandates for each health benefit plan. The commissioner of administration shall
4 request an appropriation to pay these amounts prior to implementation in the
5 subsequent plan year.
6 J. Nothing in this Section delegates or requires delegation of any state or
7 federal authority to a non-state entity, including but not limited to the authority to
8 request fiscal impact analyses from the legislative fiscal office or the authority to
9 make determinations regarding the legal status of state benefit mandates pursuant to
10 state and federal law.
11 K. Notwithstanding any other provision of law to the contrary, the
12 department shall not engage any contractor to perform an actuarial review as
13 described in this Section unless the department determines that there are adequate
14 resources available within existing appropriations to compensate the contractor for
15 actuarial review.
16 L. Any claims, reimbursement, and other data, cost estimates, and other
17 information provided by a health insurer, health plan, or other health insurance issuer
18 to a contractor, the department, or any other entity pursuant to the provisions of this
19 Section shall be kept confidential.
20 Section 2. The department shall retain contracted entities, as required in R.S.
2122:2188(A) of this Act, by December 1, 2024.
22 Section 3. The department shall convene a public meeting, as required in R.S.
2322:2188(B) of this Act, by September 1, 2024.
24 Section 4. Part VIII of Chapter 11 of Title 22 of the Louisiana Revised Statutes of
251950, comprised of R.S. 22:2187, is hereby repealed in its entirety.
26 Section 5. The Louisiana State Law Institute is hereby directed to redesignate Part
27VIII of Chapter 11 of Title 22 of the Louisiana Revised Statutes of 1950, comprised of R.S.
2822:2188, enacted by Section. 1 of this Act, as R.S. 22:2187.
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HB NO. 616
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 616 Reengrossed 2024 Regular Session Green
Abstract: Requires legislative review and actuarial analysis of proposed, mandated
healthcare legislation.
Proposed law requires the La. Dept. of Insurance (LDI) to implement a process for actuarial
reviews of healthcare legislation. By Dec. 1, 2024, proposed law requires LDI to contract
with one or more entities with experience in actuarial reviews and healthcare policy for the
purpose of performing actuarial reviews of legislative proposals.
Proposed law requires at least one of the contracted entities to be an actuary or actuarial
firm, or a university department or academic faculty based in the state of La. with experience
analyzing health insurance premiums. Further requires contractors to be independent and
free from conflicts of interest.
Proposed law requires LDI to hold a public meeting no later than Sept. 1, 2024, to obtain
input and recommendations from stakeholders.
Proposed law requires legislators requesting actuarial reviews of legislative proposals to
submit requests to LDI no later than Dec. 1st of the year preceding the regular session of the
legislature in which the legislative proposal will be proposed.
Proposed law requires contractors to consider in actuarial reviews the predicted effects of
the legislative proposal during the 5 years immediately following the effective date of the
proposal, or during another time period if such consideration is more actuarially feasible.
Predicted effects include but are not limited to certain estimated cost changes with respect
to consumer cost sharing, premiums, out-of-pocket expenses, impacts to health benefit plans,
and social and other economic impacts.
Proposed law requires contractors to provide certain information regarding actuarial reviews
including but not limited to enrollment estimates of health benefit plans and certain
disaggregated demographic information.
Proposed law provides for qualitative analysis of the impact of legislative proposals.
Authorizes a legislator who requests an actuarial review to designate one or more persons
to provide data to contractors in order to inform the qualitative analysis. Authorizes
contractors performing legislative reviews to use data from any reasonable source, including
data collected from insurers. Further requires insurers to provide information to and
cooperate with contractors and LDI.
Proposed law provides that the reports of actuarial reviews are confidential, except to the
requesting legislator or the respective chairmen of the House and Senate committees on
insurance, until the legislative proposal is introduced in the following regular legislative
session, or if no legislative proposal is introduced, until after the end of the legislative
session following the submission of the request.
Proposed law requires LDI to provide written notification to the commissioner of
administration and the chairmen of the House Appropriations Committee and Senate Finance
Committee of the estimated defrayal cost. Upon receipt of the written notification, proposed
law requires the commissioner of administration to request an appropriation to pay the
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estimated defrayal cost of each enacted legislative proposal prior to implementation in the
subsequent plan year.
Proposed law requires insurers to provide actuarial estimates, based on appropriate claims
and data of the per-member, per-month amount necessary to defray the cost of the enacted
mandate for the subsequent plan year. Requires estimates to be actuarially sound. Requires
LDI to notify the commissioner of administration and the chairmen of the House
Appropriations Committee and Senate Finance Committee of the amounts needed to defray
the cost of the enacted mandates for each health benefit plan. Further requires the
commissioner of administration to request an appropriation to pay these amounts prior to
implementation in the subsequent plan year.
Proposed law requires data and other records disclosed by a health insurer, health plan, or
other health insurance issuer pursuant to proposed law to be kept confidential.
Proposed law does not delegate state or federal authority to a non-state entity, including
authority to request fiscal impact analyses from the legislative fiscal office, or the authority
to make determinations regarding the legal status of state benefit mandates.
Proposed law prohibits LDI from engaging a contractor to perform an actuarial review
unless LDI determines adequate resources within existing appropriations for compensation.
Present law provides for the La. Mandated Health Benefits Commission. Proposed law
repeals present law and authorizes the La. State Law Institute to redesignate proposed law.
(Adds R.S. 22:2188; Repeals R.S. 22:2187)
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Insurance to the
original bill:
1. Add that a contractor may be a La.-based university department or academic
faculty with experience analyzing health insurance premiums.
2. Require the department to ensure that contractors are independent and free from
conflicts of interest that might affect neutrality of actuarial reviews.
3. Delete language relative to limiting the number of reviews to 6 legislative
proposals.
4. Require the estimate of the amounts necessary to defray the cost of the mandates
for health insurance products to include an evaluation of whether the legislative
proposal includes a mandate requiring defrayal of costs. Authorize LDI to seek
this evaluation prior to requesting the remaining actuarial review required in
proposed law.
5. Provide that proposed law does not delegate state or federal authority to a
non-state entity, including authority to request fiscal impact analyses from the
legislative fiscal office, or authority to make determinations regarding the legal
status of state benefit mandates pursuant to state and federal law.
6. Make technical changes.
The Committee Amendments Proposed by House Committee on Appropriations to the
engrossed bill:
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1. Require data and records disclosed by a health insurer, health plan, or other
health insurance issuer pursuant to proposed law to be kept confidential.
2. Make technical changes.
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