Amendment vs bill House Committee Amendment, #3699, INS, Draft vs Enrolled

Struck = removed from the bill · added = the amendment's new text.

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ENROLLED Regular Session HOUSE BILL NO.
HCAHB1154 4878 3699 HOUSE COMMITTEE AMENDMENTS Regular Session Amendments proposed byHouse Committee on Insuranceto Original House Bill No.
1154 BY REPRESENTATIVES GLORIOSO, AMEDEE, BAYHAM, BERAULT, WILFORD CARTER,CHASSION,CHENEVERT,EGAN,FREIBERG,HORTON,MILLER, OWEN, TAYLOR, AND WALTERS AN ACT To enact R.S.
1154 by Representative Glorioso AMENDMENT NO.
22:1060.1(9) through (12) and 1060.9, relative to prior authorizations for medications:
1 On page 2, line 12, after "medication" and before "if" insert "that is not an opioid," AMENDMENT NO.
to provide for requirements for certaingenericmedications prescribed byqualifiedphysiciansorauthorizedproviders;toprovidefordefinitions;torequire healthinsurancecoverageformedication;toprovideforapplicability;andtoprovide for related matters.
2 On page 2, line 14, after "prescribed" and before the period "." insert "and the wholesale acquisition cost is no more than two hundred fifty dollars per prescription" AMENDMENT NO.
Be it enacted by the Legislature of Louisiana:
3 On page 2, line 19, after "physician" and before "whose" insert "or authorized provider" Page 1 of 1 CODING:
Section 1.
R.S.
22:1060.1 (9) through (12) and 1060.9 areherebyenactedto readas follows:
§1060.1.
Definitions As used in this Subpart, the following definitions apply:
* * * (9) "Board-certified physician" means a physician licensed to practice medicine in this state who is certified bya member board of the American Board of Medical Specialties or an equivalent certifying body recognized by the Louisiana State Board of Medical Examiners.
(10) "Commercial insurer" means any health insurance issuer, health maintenance organization, or other entity that offers a health benefit plan through a policy, contract, or certificate of insurance that covers prescription drugs and is authorizedtoprovidehealthinsurancecoverageinthisstate,excludingfederal,state, or local governmental plans such as Medicaid.
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Wordsinstruckthroughtypearedeletionsfromexistinglaw;wordsunderscored are additions.
HB NO.
1154 ENROLLED (11) "Generic medication" means a drug that is chemically equivalent to a brand-namedrugand approved bythe United States Food and DrugAdministration as interchangeable.
(12) "Prior authorization" means a utilization review process requiring approval from the insurer before a prescribed medication can be dispensed or reimbursed.
* * * §1060.9.
Prohibition on prior authorization for generic medications;
conditions Acommercialinsurershallnot 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.
Section 2.
The provisions of this Act shall apply to any new policy, contract, or health coverage plan issued on and after January 1, 2027.
Any policy, contract, or health coverage plan in effect prior to January1, 2027, shall convert to conform to the provisions of this Act on or before the renewal date, but no later than January 1, 2028.
SPEAKER OF THE HOUSE OF REPRESENTATIVES PRESIDENT OF THE SENATE GOVERNOR OF THE STATE OF LOUISIANA APPROVED:
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