HB 1235 requires health insurance plans to cover prosthetic and custom orthotic devices and services based on medical necessity, as determined by the insured's doctors and specialists. The bill mandates that coverage levels must at least match federal standards for the elderly and disabled, while also prohibiting blanket exclusions for items used in physical activities or daily hygiene. Additionally, the legislation establishes specific appeal processes for denied claims and outlines detailed factors insurers must consider when evaluating medical necessity, such as the patient's current condition and functional needs.
HB 740 creates an independent review process for Medicaid claims related to the Coordinated System of Care (CSoC) program in Louisiana. It directly affects behavioral health providers and families enrolled in CSoC, which serves youth with significant behavioral health challenges who are in or at risk of out-of-home placement. The bill establishes that claims denials for CSoC services must undergo review by an independent third party, rather than being handled under the standard Medicaid managed care process. This change ensures CSoC-specific claims get specialized review, addressing gaps in the current system for this vulnerable population.
This bill directs the Louisiana Department of Health to conduct a study identifying gaps in acute healthcare access for individuals with intellectual and developmental disabilities. The legislation also establishes a committee to oversee this study, which will include representatives from the House and Senate, as well as one member appointed by the Senate president. The primary goal is to gather data on where and how these individuals face barriers in receiving timely medical care. Once the study is complete, the department is required to submit a report detailing its findings to the legislature.
SB 501, known as the Campus Awareness Initiative, requires public colleges and universities in Louisiana to display specific signs in student health centers. These signs, which must feature the message "Worried about STIs? Just Check!" along with a link to state resources, aim to promote awareness of sexually transmitted infection prevention, screening, and treatment. The Louisiana Department of Health or a designated nonprofit organization is responsible for designing and producing these durable signs, though the department may use donated funds or accept donated signs to cover costs. This bill directly affects public postsecondary institutions and their health services by mandating the placement of these informational displays in patient admission, waiting, and consultation areas.
This Louisiana concurrent resolution requests that the United States Congress classify the Doctor of Physical Therapy degree as a professional degree eligible for enhanced federal student loan borrowing limits. The measure aims to allow physical therapy students to access higher levels of federal financial aid, similar to other professional degree programs, rather than being restricted by lower undergraduate loan caps. It specifically targets students pursuing physical therapy education in Louisiana to support workforce development and address healthcare needs in the state. As a memorial resolution, this document does not change state law directly but formally asks the federal government to adjust eligibility rules for student loans.
This bill prohibits health insurance companies and Medicaid managed care organizations from requiring prior authorization for certain generic medications when prescribed by board-certified physicians. The law defines a board-certified physician as a doctor certified by a recognized medical specialty board and a generic medication as a drug chemically equivalent to a brand-name drug approved by the FDA. Under this legislation, insurers must cover these specific generic prescriptions without needing additional approval from the insurance company before dispensing or reimbursing them. The restrictions apply to new insurance policies and contracts starting January 1, 2027, with existing plans required to comply by January 1, 2028.
HB 222 requires Louisiana Medicaid to cover dental procedures when they are medically necessary for a patient to safely receive another Medicaid-covered medical treatment. This directly affects Medicaid enrollees who need dental care as a prerequisite for other covered medical procedures, such as surgeries or chronic condition management. The bill mandates the Louisiana Department of Health to update the state’s federal Medicaid plan, create necessary administrative rules, and submit required amendments to the Centers for Medicare and Medicaid Services. It does not expand general dental coverage but targets specific cases where dental treatment is a medical necessity for other covered care.
HB 218 requires Louisiana public schools to screen all students in grades K-12 for food insecurity at enrollment and once per semester, plus during school health clinic visits. The bill mandates using a free, age-appropriate screening tool selected by the state Department of Education and Health, with results kept confidential except for parents/guardians or authorized school staff. Schools must refer identified students to resources like meal programs, food pantries, and public assistance. Charter schools are exempt from this requirement under Section 3996(B)(24), but the bill applies directly to public school students and their families.
HB 198 requires Louisiana's Medicaid program to reimburse ambulatory surgical centers at least 100% of the Medicare rate for gastroenterology procedures. This directly affects outpatient surgical centers providing these specific medical services and ensures they receive consistent, updated payments. The bill mandates annual reimbursement adjustments to match Medicare rate changes and requires the Louisiana Department of Health to implement these changes by October 1, 2026. It also authorizes the Department to create necessary rules under state administrative procedures. This policy change standardizes payments for a defined set of procedures, aiming to maintain provider access to Medicaid coverage.
HCR 3 establishes a quarterly assessment on Louisiana hospitals to stabilize funding without using state general funds. It requires hospitals to pay a percentage of their inpatient and outpatient revenue (ranging from 1.38% to 6.74%, with exemptions for rural hospitals and small facilities under 40 beds). The collected funds support Medicaid reimbursement enhancements for hospitals, ensuring payments meet or exceed 2026 rates while aligning with federal CMS guidelines. This directly affects most acute care hospitals in Louisiana, excluding rural and small facilities, and aims to preserve hospital services for all residents.
