HB 430, known as the "MJ 911 Act," mandates that Lafayette Parish employers provide lifelong health insurance coverage for surviving spouses and children (including step- or adopted children) of law enforcement officers or firefighters killed in the line of duty. Specifically, it requires employers to pay for health insurance for surviving spouses for life and for children until age 18 (or until 23 if enrolled in school or disabled). The law applies retroactively to January 1, 2017, for all qualifying families and ensures coverage matches what active members receive. It does not require families to accept the coverage, allowing them to decline it if desired.
SB 295 requires all health insurance plans sold in Louisiana to cover medically necessary treatments for people with acquired brain injuries (ABIs), such as stroke or trauma survivors. It prohibits lifetime or unreasonable annual limits on treatment days/sessions, ensures ABI care isn’t subject to higher deductibles/copays than other benefits, and bans coverage denials based solely on treatment location (e.g., home vs. facility) if clinically appropriate. The bill defines covered services to include cognitive rehabilitation, neurobehavioral therapy, and community reintegration support, and mandates peer-reviewed appeals for denied claims. The bill is pending in the Insurance Committee after being prefilled in February 2026.
SB 381 (Louisiana) regulates pharmacy benefit managers (PBMs) by requiring them to pass all drug manufacturer rebates directly to health plans as lower premiums or reduced patient costs, rather than keeping them. It prohibits PBMs from withholding rebates to exclude generic or cheaper drugs from formularies and bans requiring patients to use more expensive brand-name drugs when cheaper alternatives exist. The bill also mandates a 60-day transition period for patients when a drug is removed from a formulary, ensuring continuity of care during plan changes. These provisions directly affect PBMs, health insurers, pharmacies, and patients in Louisiana by increasing transparency and reducing out-of-pocket costs. The bill is pending legislative action as of its prefiling date.
HB 452 prohibits health insurance plans from offering extra payments to healthcare providers to encourage administering vaccinations or denying reimbursement/charging penalties to influence vaccination rates. It directly affects insurance companies and healthcare providers by banning financial incentives or penalties tied to vaccine administration. The law applies to most health insurance plans (including employer-sponsored and HMO plans) but excludes limited benefit plans and short-term policies. This creates a clear policy change: insurers cannot use financial pressure to steer providers toward or away from vaccinating patients.
HB 291 prevents health insurers in Louisiana from penalizing hospitals or clinics (participating healthcare facilities) solely because another provider at that facility - like a doctor or specialist - is dropped from the insurer's network. The bill directly affects healthcare facilities that coordinate patient care with multiple providers, ensuring they won’t face payment cuts or contract terminations due to a partner provider’s network status. Key provisions ban insurers from reducing payments or ending agreements with facilities based on another provider’s network exclusion, and require that any contract clauses attempting to override this rule are void. This policy change aims to stabilize provider relationships and care continuity for patients.
SB 169 requires health insurance plans in Louisiana to cover biomarker testing for patients needing personalized medical treatment, such as cancer care guided by genetic markers. It defines "clinical utility" through specific criteria to ensure tests are covered without unnecessary hurdles. The law prevents insurers from denying coverage based on laboratory classifications or unrelated credentialing, ensuring the test itself - not the lab - is the focus of coverage. This directly affects patients seeking biomarker tests and insurers, reducing the need for repeated biopsies by mandating seamless coverage.
HB 95 limits the amount a person can recover for medical expenses after a car accident if they had health insurance but didn't use it. It caps compensation at what their health insurance would have paid for those medical costs. This applies to standard car accident claims but does not affect workers' compensation cases under Louisiana law. The bill ensures health insurance coverage must be utilized before seeking full recovery for accident-related medical bills.
HB 771 requires health insurers to treat Medicare as the primary payer for retirees who return to work and receive employer-sponsored health coverage, meaning Medicare covers costs first rather than secondary. It applies specifically to Medicare-eligible retirees who previously retired but are now reemployed under an employer health plan regulated under state law. The bill mandates insurers coordinate payments this way unless federal law (like 42 CFR §411.32) requires otherwise, without changing existing coverage benefits. This clarifies payment order between Medicare and employer plans for affected retirees.
HB 774 requires health insurance companies in Louisiana to cover hearing aids for children under 18 and young adults up to age 26 who are already covered under their insurance policy. The bill mandates that coverage must be provided by a licensed audiologist or hearing aid specialist after a physician's medical clearance and a medically appropriate audiological evaluation. This change applies directly to insured individuals in these age groups and overrides previous insurance coverage limitations (R.S. 22:1047). The law ensures that hearing aid coverage is tied to medical necessity and professional evaluation, rather than being excluded under standard policy terms.
