Healthcare (Prescription Drugs)

in committee · Louisiana · Senate May 5, 2026

SB 363: HEALTH/ACC INSURANCE: Provides for health insurance. (8/1/26)

SB 363 requires health insurance companies in Louisiana to provide medically necessary treatments as determined by a patient's treating provider, prohibiting substitutions with less intensive care solely based on cost-saving measures. It directly affects health insurance issuers and patients who might face denied or downgraded care. The bill defines "lower level of care" as less intensive treatment than recommended by the provider and specifies that substitutions are only allowed if consistent with standard medical practice and clinically appropriate. This policy change aims to prevent insurers from overriding provider recommendations for financial reasons. The bill is currently pending referral to the Insurance Committee after being prefaced in February 2026.

Topics ✓ HealthcareSupports HealthcareProhibits insurers from substituting medically necessary care for cost-saving reasons, directly protecting patient access to recommended treatments and provider determinations.95% confidence

Sub-Topics Insurance Prescription Drugs

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signed · Louisiana · House Jun 12, 2026

HB 870: INSURANCE/HEALTH: Provides relative to formulary placement and cost-sharing requirements for certain generic drugs and biosimilars (EN NO IMPACT See Note)

HB 870 requires Louisiana health insurance issuers to immediately place cheaper generic drugs and biosimilars on more favorable formulary tiers (with lower out-of-pocket costs) when their wholesale acquisition cost is lower than the brand-name reference drug or product. Specifically, if a generic drug costs less than its brand-name equivalent at launch, insurers must cover it with better cost-sharing and cannot impose prior authorization, step therapy, or pharmacy restrictions that make it harder to access than the brand. The same rules apply to biosimilars that are cheaper than their reference biological products. This directly affects health insurance plans and enrollees seeking coverage for these cost-effective alternatives. The bill aims to reduce patient costs by mandating insurer action when cheaper, equivalent options become available.

Topics ✓ HealthcareSupports HealthcareRequires insurers to place cheaper generics on lower-cost tiers with no prior authorization, directly improving patient access and reducing out-of-pocket costs for essential medications.95% confidence

Sub-Topics Insurance Prescription Drugs

in committee · Louisiana · House Mar 9, 2026

HB 918: PHARMACIES: Provides relative to pharmaceutical costs (OR +$153,127 GF EX See Note)

HB 918 requires Louisiana's Department of Health to create a list of "critical prescription drugs" based on factors like cost to Medicaid, usage, and availability of alternatives. Drug manufacturers must report detailed cost data (including production, R&D, marketing, and international pricing) for drugs on this list. The bill also mandates that marketing materials to healthcare providers include current wholesale prices for each drug. These transparency measures aim to inform pricing decisions without directly setting drug costs.

Topics ✓ HealthcareSupports HealthcareBill mandates drug cost transparency to inform pricing decisions, potentially reducing costs for patients and Medicaid through mandatory manufacturer reporting and wholesale price disclosures.85% confidence

Sub-Topics Medicaid Prescription Drugs

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died · Louisiana · Senate May 28, 2026

SB 246: HEALTH/ACC INSURANCE: Establishes requirements for health insurance issuers using artificial intelligence or automated decision systems. (8/1/26)

SB 246 requires health insurers and related entities (like pharmacy benefit managers) to disclose when artificial intelligence (AI) is used in denying coverage decisions. The bill prohibits AI from discriminating, violating health regulations, or delaying care, and mandates that AI decisions must be based on individual patient medical history - not group data - and include human review for medical necessity claims and prior authorization requests. Insurers must also conduct quarterly AI performance reviews, allow patients to request AI-related documentation, and cannot use AI in subsequent reviews of appeals where AI was the basis for denial.

Topics ✓ HealthcareSupports HealthcareRequires insurers to disclose AI use in coverage denials, prohibits discrimination/delays, mandates individual data use & human review - protects patient rights in healthcare decisions.95% confidence ✓ TechnologySupports TechnologyBill mandates transparency and prevents AI discrimination in health insurance decisions, requiring human review and individual medical history use, aligning with consumer protection regulations for technology use.95% confidence

Sub-Topics Insurance Prescription Drugs Artificial Intelligence

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signed · Louisiana · Senate Jun 12, 2026

SB 401: PHARMACEUTICALS: Provides for a Prescription Drug Affordability Board. (8/1/26)

SB 401 establishes a Prescription Drug Affordability Board within Louisiana's Department of Insurance to address rising prescription drug costs. The board would require drug manufacturers to report detailed pricing data - including production costs, research expenses, and marketing costs - and develop a list of "critical" drugs based on factors like public healthcare costs, usage, and availability of similar treatments. For drugs on this list, the board would set maximum allowable prices for sale in Louisiana, directly affecting manufacturers, pharmacies, and residents who purchase these medications. The bill aims to increase price transparency and control costs through data-driven price-setting, but it has not yet been enacted as it remains prefiling status.

Topics ✓ HealthcareSupports HealthcareSets maximum drug prices to reduce costs, improving patient affordability and access to prescription medications.95% confidence

Sub-Topics Prescription Drugs

passed · Louisiana · House May 14, 2026

HB 938: INSURANCE/HEALTH: Provides relative to pharmacy benefit managers (RE +$3,187,173 SG EX See Note)

HB 938 requires pharmacy benefit managers (PBMs) in Louisiana to reimburse pharmacies at the National Average Drug Acquisition Cost (NADAC) plus a standard dispensing fee for all prescriptions, regardless of whether the pharmacy is independent or affiliated with the PBM. It prohibits PBMs from retaining rebates from drug manufacturers, mandating that all rebates be passed through to health plan sponsors as lower premiums, reduced patient costs, or broader coverage. The bill also limits payment errors to a 2% rate for prescription claims, establishes a formal appeal process for pharmacies disputing underpayments, and grants state regulators access to PBM data for oversight. This directly affects Louisiana pharmacies, PBMs, and health plans by standardizing payments, increasing transparency, and reducing financial disputes.

Topics ✓ HealthcareSupports HealthcareRequires PBMs to pass rebates to health plans, lowering premiums/patient costs and mandating fair pharmacy reimbursement, directly improving patient access and reducing drug costs.95% confidence

Sub-Topics Insurance Prescription Drugs

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passed · Louisiana · House Mar 30, 2026

HB 469: PHARMACISTS: Provides relative to the pharmacy education support fee collected by the Louisiana Board of Pharmacy

HB 469 establishes a $100 annual optional "pharmacy education support fee" for pharmacists and pharmacies renewing licenses or permits in Louisiana. Pharmacists and pharmacies can choose whether to pay the fee or select a specific public university pharmacy school (like Xavier University) to receive it, with the option to opt out entirely. Funds collected must supplement, not replace, existing university funding for pharmacy education programs. The Louisiana Board of Pharmacy will distribute payments to chosen schools by April 1 each year, ensuring the money directly supports pharmacy education initiatives at public universities.

Topics ✓ EducationSupports EducationEstablishes $100 annual fee to fund pharmacy education programs, supplementing existing university funding for pharmacy schools like Xavier University.95% confidence ✓ HealthcareSupports HealthcareFunds pharmacy education programs to support healthcare workforce development, advancing medical professional training under healthcare topic.75% confidence

Sub-Topics Higher Education Prescription Drugs

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in committee · Louisiana · Senate Apr 8, 2026

SB 369: PHARMACEUTICALS: Provides for prescription drug pricing. (1/1/27) (EG SG EX See Note)

SB 369 requires Louisiana's state insurance plans (like Medicaid or Group Benefits) to pay pharmaceutical manufacturers no more than Medicare's price for covered drugs. It also prohibits insurers and pharmacy benefit managers from reimbursing less than Medicare's price for any brand-name, biosimilar, or generic drug. This sets Medicare's price as both a maximum for state plan purchases and a minimum for reimbursement, directly affecting drug manufacturers, insurers, and pharmacies serving Louisiana's state health programs. The bill takes effect January 1, 2027, and authorizes the state insurance commissioner to enforce these rules.

Topics ✓ HealthcareSupports HealthcareSets Medicare price as max for state purchases and min for reimbursement, capping drug costs for Medicaid/insurers to improve affordability and access to medications.95% confidence

Sub-Topics Medicaid Medicare Prescription Drugs

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in committee · Louisiana · Senate Mar 9, 2026

SB 372: HEALTH/ACC INSURANCE: Provides relative to pharmacy benefit managers. (8/1/26)

SB 372 expands the Louisiana Insurance Commissioner's authority to examine pharmacy benefit manager (PBM) financial records. It allows the commissioner to access detailed payment data between insurers, PBMs, and pharmacies to verify the accuracy of required transparency reports. The bill specifically authorizes review of individual drug payment amounts paid by insurers to PBMs and by PBMs to pharmacies. This directly affects PBMs, insurers, and pharmacies by increasing oversight of their financial transactions. The law aims to improve transparency in how PBMs handle drug payments within the insurance system.

Topics ✓ HealthcareSupports HealthcareExpands oversight of PBM financial transparency to ensure accurate reporting, promoting accountability in pharmacy benefit management affecting healthcare costs and patient access.85% confidence

Sub-Topics Prescription Drugs

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in committee · Louisiana · Senate Mar 9, 2026

SB 368: PHARMACEUTICALS: Provides for prescription drug pricing. (8/1/26) (OR +$270,360 SG EX See Note)

SB 368 requires pharmaceutical manufacturers to report price increases for prescription drugs that exceed annual changes in the Consumer Price Index for prescription drugs, or when introducing new specialty drugs. Manufacturers must provide detailed cost explanations, including production costs, research and development expenses, and marketing costs. The Louisiana Department of Insurance and Department of Health will make this information publicly accessible online and require annual reports tracking drug pricing trends and the top 25 costliest drugs. The bill also establishes penalties for non-compliance and allows state agencies to audit reporting entities. (Note: This bill is currently pending and not yet enacted.)

Topics ✓ HealthcareSupports HealthcareRequires drug manufacturers to disclose pricing details and cost breakdowns, increasing transparency to address high prescription drug costs and improve patient access.90% confidence

Sub-Topics Prescription Drugs

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