HLS 25RS-975 ORIGINAL
2025 Regular Session
HOUSE BILL NO. 595
BY REPRESENTATIVE PHELPS
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
MEDICAID: Provides relative to Medicaid coverage through the TEFRA option program
1 AN ACT
2To enact R.S. 46:977.24(A)(8), relative to Medicaid coverage; to provide for Medicaid
3 coverage through the TEFRA option; to provide for eligibility; to provide for the
4 treatment of a severe health condition; and to provide for related matters.
5Be it enacted by the Legislature of Louisiana:
6 Section 1. R.S. 46:977.24(A)(8) is hereby enacted to read as follows:
7 ยง977.24. Eligibility factors; benefits; premium payment program participation
8 A. In order to be eligible for the TEFRA option, a child shall meet all of the
9 following eligibility criteria:
10 * * *
11 (8) Due to his disability, he presents for emergency care in a hospital
12 emergency department more frequently than once per month. The child satisfies this
13 eligibility criteria if his physician determines that use of the emergency room is
14 necessary to stabilize a condition, such as acute chest syndrome, as a result of his
15 disability even if the child is not admitted to the hospital for inpatient treatment.
16 * * *
Page 1 of 2
CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HLS 25RS-975 ORIGINAL
HB NO. 595
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 595 Original 2025 Regular Session Phelps
Abstract: Adds eligibility criteria used to determine a child's eligibility for Medicaid
coverage through the TEFRA option.
Present law allows eligible children to obtain Medicaid, regardless of parent income, through
the TEFRA option if they meet the following eligibility criteria:
(1)He is a Louisiana resident and United States citizen.
(2)He is under the age of nineteen.
(3)He has a disability that is recognized under the definition of disability utilized in the
Supplemental Security Income program of the Social Security Administration,
regardless of whether he is eligible to receive benefits under that program.
(4)He is ineligible for Medicaid coverage when the income of his parents is considered.
(5)Excluding the assets of his parents, he does not have total assets exceeding two
thousand dollars in value.
(6)Due to his disability, he requires a level of care provided in a hospital, skilled
nursing facility, or intermediate care facility; however, care provided outside of such
an institution may be appropriate.
(7)The cost of his care provided at his home is less than the cost of institutional care.
Proposed law modifies present law adding that a child may qualify for TEFRA if, due to his
disability, he presents in the hospital for emergency care more than once per month.
Proposed law further provides that a child satisfies this eligibility criteria if his physician
determines that use of the emergency room is necessary to stabilize a condition, such as
acute chest syndrome, as a result of his disability even if the child is not admitted to the
hospital for inpatient treatment.
(Adds R.S. 46:977.24(A)(8))
Page 2 of 2
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.