HB 1154 — INSURANCE: Prohibits prior authorizations requirements for certain generic medications prescribed by qualified physicians (EN NO IMPACT GF EX See Note)

HLSENROLLED 26RS-2660 RE-REENGROSSED Regular Session HOUSE BILL NO.

1154 BY REPRESENTATIVES GLORIOSO, AMEDEE, BAYHAM, BERAULT, WILFORD CARTER,CHASSION,CHENEVERT,EGAN,FREIBERG,HORTON,MILLER, OWEN, TAYLOR, AND WALTERS INSURANCE:AN ACT To enact R.S.

Prohibits prior authorizations requirements for certaingeneric medications prescribed by qualified physicians or authorized providers AN ACT To enact R.S.

to provide for requirementsforrequirements certainfor genericcertaingenericmedications medications prescribed byqualifiedphysiciansorauthorizedproviders;toprovidefordefinitions;torequire healthinsurancecoverageformedication;toprovideforapplicability;andtoprovide for related matters.

22:1060.1 (9) through (12) and 1060.9 areherebyenactedareherebyenactedto to readas follows:

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HLS 26RS-2660 RE-REENGROSSED HB NO.

1154 ENROLLED (11) "Generic medication" means a drug that is chemically equivalent to a brand-namedrugbrand-namedrugand and approved bythe United States Food and DrugAdministration as interchangeable.

conditions AcommercialinsurershallnotrequirepriorauthorizationforthedispensingAcommercialinsurershallnot requirepriorauthorizationforthedispensing orreimbursementofagenericmedicationthatisnotanopioid,iftheprescriptionfor themedicationisissuedbyaboard-certifiedphysicianorauthorizedproviderwhose specialty certification includes the medical indication for which the drug is prescribed and the wholesale acquisition cost is no more than two hundred fifty dollars per prescription.

Any policy, contract, or health coverage plan in effect prior to JanuaryJanuary1, 1, 2027, shall convert to conform to the provisions of this Act on or before the renewal date, but no later than January 1, 2028.

DIGESTSPEAKER ThedigestprintedbelowwaspreparedbyHouseLegislativeOF Services.THE HOUSE OF REPRESENTATIVES PRESIDENT OF THE SENATE GOVERNOR OF THE STATE OF LOUISIANA APPROVED:

ItPage constitutes2 nopart of the2 legislativeCODING: 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 1154 Re-Reengrossed 2026 Regular Session Glorioso Abstract:

Prohibits commercial insurers from requiring prior authorizations for certain genericmedicationswhenprescribedbyqualifiedphysiciansorauthorizedproviders.

Present law defines certain terms.

Proposed law adds the terms "board-certified physician", "commercial insurer", "generic medication", and "prior authorization", and otherwise retains present law.

Proposedlawprohibitscommercialinsurersfromrequiringapriorauthorizationforgeneric medications that are not opioids when prescribed by a board-certified physician or authorized provider whose specialtycertification includes the medical indication for which the drug is prescribed and the wholesale acquisition cost is no more than $250 per prescription.

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Wordsinstruckthroughtypearedeletionsfromexistinglaw;wordsunderscored are additions.

HLS 26RS-2660 RE-REENGROSSED HB NO.

1154 Proposed law clarifies that the terms used in proposed law have the same meaning as provided for in proposed law.

Proposedlawappliestoanynewpolicy,contract,orhealthcoverageplanissuedonandafter Jan.

1, 2027.

Proposed law requires any policy, contract, or health coverage plan in effect prior to Jan.

1, 2027, to convert to conform to the provisions of proposed law on or before the renewal date, but no later than Jan.

1, 2028.

(Adds R.S.

22:1060.1(9)-(12) and 1060.9) Summary of Amendments Adopted by House The Committee Amendments Proposed by House Committee on Insurance to the original bill:

1.

Add to the commercial insurer prohibition that generic medications that are not opioids do not require a prior authorization when prescribed and the wholesale acquisition cost is no more than $250 per prescription.

2.

Prohibit Medicaid managed care organizations from requiring a prior authorizationforgenericmedicationswhenprescribedbyanauthorizedprovider whose specialtycertification includes the medical indication for which the drug is prescribed.

3.

Make technical changes.

The Committee Amendments Proposed by House Committee on Appropriations to the engrossed bill:

1.

Remove Medicaid managed care organizations from proposed law.

2.