Amendment vs bill House Committee Amendment, #4567, APP, Adopted vs Enrolled

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ENROLLED Regular Session HOUSE BILL NO.
HCAHB1154 4448 4567 HOUSE COMMITTEE AMENDMENTS Regular Session AmendmentsproposedbyHouseCommitteeonAppropriationstoEngrossedHouseBillNo.
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.
by Representative Glorioso AMENDMENT NO.
22:1060.1(9) through (12) and 1060.9, relative to prior authorizations for medications:
1 On page 1, line 2, after "through (12)" and before "relative" delete "and 1060.9 and R.S.
to provide for requirements for certaingenericmedications prescribed byqualifiedphysiciansorauthorizedproviders;toprovidefordefinitions;torequire healthinsurancecoverageformedication;toprovideforapplicability;andtoprovide for related matters.
46:153.3.3," and insert "and 1060.9," AMENDMENT NO.
Be it enacted by the Legislature of Louisiana:
2 On page 2, line 7, after"insurer"and before"before"delete "or managed careorganization" AMENDMENT NO.
Section 1.
3 On page 2, delete lines 16 through 28 in their entirety, and insert the following:
R.S.
"Section 2.
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.
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.
Any policy, contract, or health coverage plan in effect prior to" Page 1 of 1 CODING:
SPEAKER OF THE HOUSE OF REPRESENTATIVES PRESIDENT OF THE SENATE GOVERNOR OF THE STATE OF LOUISIANA APPROVED:
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