State Advocacy

Legislative Highlights

Each year MedicineLouisiana influences numerous pieces of legislation that directly impact Louisiana physicians. Below are weekly recaps and bill summaries from the current 2017 Regular Legislative Session – please visit the links to see each instrument in its entirety.

2019 Session Results

Balance Billing

HB371 would have provided for an independent dispute resolution process in balance billing situations.

General

SB 177 would have provided that no contract, agreement or provision thereof shall be enforceable to restrict any physician, advanced practice registered nurse, nurse practitioner, or physician assistant from practicing, upon termination of employment or independent contractor agreement, who has practiced in their field for a five-year continuous period with the same employer or affiliate in the same community while subject to a noncompete or nonsolicitation agreement. .

Insurance

HB 345 requires any health coverage plan delivered or issued for delivery in this state to include coverage for the cost of the genetic testing of the BRCA1 and BRCA2 genes to detect an increased risk for breast and ovarian cancer when recommended by a healthcare provider in accordance with the United States Preventive Services Task Force recommendations for testing.

HB 347 provides for the coverage of diagnostic imaging at the same level of coverage as screening mammograms.

Medicaid

HB 424 requires that if a claim is denied by the MCO based upon an opinion or interpretation by the MCO of a law, regulation, policy, procedure, or medical criteria or guideline, then the MCO shall provide with the remittance advice either instructions for accessing the applicable law, regulation, policy, procedure, or medical criteria or guideline in the public domain or an actual copy of that law, regulation, policy, procedure, or medical criteria or guideline.

The prior authorization requirements of LDH and each MCO, including prior authorization requirements applicable in the Medicaid pharmacy program, shall either be furnished to the healthcare provider within twenty-four hours of a request for the requirements or posted in an easily searchable format on the website of the respective managed care organization or the department.

HB 434 requires LDH to publish on its website a copy of the entire proposed contract amendment and provide a public comment period of no less than thirty days prior to executing any amendment to a professional, personal, consulting, or social services contract that provides for managed care under the Louisiana Medical Assistance, to publish proposed Medicaid policy or procedure for a period of no less than forty-five days for the purpose of soliciting public comment and prohibits the implementation of a policy or procedure proposed by a managed care organization unless the department has provided its express written approval to the managed care organization.

Medical

SB 184 prohibits the abortion of a fetus with a detectable heartbeat with the exception of preventing the death of a pregnant woman or to prevent a serious risk of the substantial and irreversible impairment of a major bodily function of the pregnant woman. For purposes of this Section, “abortion” shall not include an abortion performed when the pregnancy is diagnosed as medically futile.

The law provides for criminal penalties and grounds for discipline against the physician’s license. This law will only become effective upon a ruling by the US Supreme Court or an amendment to the US Constitution.

Prescriptions

HB 285 provides administrative simplification for prescribers relative to the denial of a prescription based upon step therapy or fail first protocols or non-formulary status. If a prescribed drug is denied by a health coverage plan based upon step therapy or fail first protocols, the health coverage plan shall provide the prescriber with a list of the alternative comparable formulary medications in writing and attached to the letter of denial of prescription drug coverage

HB 284 is relative to prescribing and dispensing of opioid drugs and requires the medical practitioner to denote on the prescription that more than a seven-day supply of the opioid is medically necessary.

SB 53 provides that the Board of Pharmacy may provide prescription monitoring information in response to queries from prescription monitoring programs, electronic health information systems, and pharmacy information systems located in other states, territories, federal districts, and federal jurisdictions, through its participation in a secure interstate data exchange system.

Regulations

HB 282 was filed on behalf of LDH, but the author did not move the legislation forward. The bill would have required a treatment center that is operated primarily for the purpose of offering endovascular surgical services to comply with the requirements in the Ambulatory Surgical Centers Licensing Law.

HB 536 provides for the definition of a free-standing birth center and for the process of licensing free standing birth centers.

SB 36 provides for the definition of free-standing emergency departments and prohibits them in Louisiana.

Scope of Practice

HB 276 would have granted advanced practice registered nurses signature authority but was defeated on the House floor. The controversial language stated that if a provision of law or administrative rule requires a signature, certification, stamp, verification, affidavit, or endorsement by a physician, the requirement may be fulfilled by an advanced practice registered nurse practicing within his scope of practice unless prohibited by the terms of a collaborative practice agreement to which the nurse is a party.

SB 166 provides for physician assistants’ referral for direct occupational therapy. The initial language which was removed would have changed “supervision” to “collaboration” in the physician /PA relationship and would have transferred legal liability