The original instrument and the following digest, which constitutes no part of the
legislative instrument, were prepared by Brandi Cannon.
DIGEST
SB 241 Original 2024 Regular Session Talbot
Present law prohibits a health insurance issuer, pharmacy benefit manager, or their agent from
refusing to authorize, approve, or pay a participating provider for providing covered
physician-administered drugs and related services to covered persons.
Proposed law retains present law.
Present law prohibits a health insurance issuer, pharmacy benefit manager, or their agent from
conditioning, denying, restricting, refusing to authorize or approve, or reducing payment to a
participating provider for a physician-administered drug when all criteria for medical necessity are
met because the participating provider obtains physician-administered drugs from a pharmacy that
is not a participating provider in the health insurance issuer's network.
Proposed law retains present law and extends the payment protection to apply to a physician-
administered drug that is obtained from a wholesaler, distributor, or other source not selected by the
health insurance issuer, pharmacy benefits manager, or their agent.
Effective upon signature of the governor or lapse of time for gubernatorial action.
(Amends R.S. 22:1020.53(A)(1))