Louisiana Administrative Code

A. Regulation 97 is promulgated by the commissioner pursuant to the authority granted under the Louisiana Insurance Code, R.S. 22:1 et seq., particularly R.S. 22:11, and specifically R.S. 22:1457(E).

A. For the purposes of Regulation 97 these terms shall have the meaning ascribed herein unless the context clearly indicates otherwise. Commissioner—Commissioner of Insurance. Insurer—any authorized insurance company which possesses a certificate of authority issued by the Commis…

A. Upon application by an insurer, an actuarially justified rate reduction for the installation of a vehicle tracking system shall be approved by the commissioner, in accordance with law. The rate reduction filed by the insurer shall apply to either motor vehicle liability covera…

A. Regulation 97 shall become effective upon final publication in the Louisiana Register and shall apply to acts or practices committed on or after the effective date.

A. If any Section or provision of Regulation 97 or the application to any person or circumstance is held invalid, such invalidity or determination shall not affect other Sections or provisions or the application of Regulation 97 to any persons or circumstances that can be given e…

A. An HIV-related test is a test which is performed solely for the purpose of identifying the presence of antibodies or antigens indicative of infection with Human Immunodeficiency Virus (HIV) including but not limited to: HIV antibody ELISA, Western blot and Immunoflourescent As…

A. Informational Provisions. Prior to the execution of informed consent, the health care provider requesting the performance of an HIV-related test shall provide to the subject of an HIV-related test, or, if the subject lacks capacity to consent, to a person authorized by law to …

A. Provision for Refusal of Disclosure. Except as otherwise provided by law or regulation, no person who obtains, retains, or becomes the recipient of confidential HIV test results in the course of providing any health or social service or pursuant to a release of confidential HI…

A. With the exception of §13505.B.12, in the case of a person applying for or already insured under an insurance policy who will be or has been the subject of a test to determine infection for human immunodeficiency virus (HIV), all facets of insurers’ practices in connection wit…

A. The Department of Health and Hospitals, Office of Public Health has developed forms for obtaining informed consent for HIV testing, for release of medical information, and a brochure to provide information to a person being tested for HIV pursuant to Act 1054. These forms are …

A. Regulation 93 is issued pursuant to the authority vested in the commissioner pursuant to the provisions of R.S. 49:953 et seq., of the Administrative Procedure Act; R.S. 22:11, R.S. 22:1333(D) and 22:1265(F).

A. The purpose of Regulation 93 is to implement the provisions of Acts 2008, No. 854 of the Regular Session of the Louisiana Legislature, which allows an insurer to make a filing to deviate from the requirements of R.S.22:1333(C) and 22:1265(D) concerning deductibles for named st…

A. Regulation 93 applies to authorized property and casualty insurers required to submit rates and rating plans for residential property insurance to the Louisiana Department of Insurance. B. Regulation 93 applies to approved unauthorized insurers, i.e., surplus lines. C. Regulat…

A. As used in Regulation 93, these terms shall have the following meaning ascribed herein unless the context clearly indicates otherwise. Commissioner―the Commissioner of Insurance for the State of Louisiana. Department―Louisiana Department of Insurance. Deductible―a named storm …

A. Any authorized property and casualty insurer that makes a filing pursuant to R.S. 22:1464 for authorization to deviate from the requirements of R.S.22:1333(C) and 22:1265(D) concerning deductibles for named storms and hurricanes shall file with the Commissioner a business plan…

A. The Commissioner may subsequently rescind his approval of any filing made pursuant to this Subsection if the insurer fails to write new business in accordance with the business plan filed with and approved by the Commissioner pursuant to R.S. 22:1333(D) and 22:1265(F). B. If a…

A. Any insurer receiving approval to deviate from the requirements of R.S. 22:1333(C) and 22:1265(D) concerning deductibles for named storms and hurricanes as a result of a filing made pursuant to Regulation 93 and R.S. 22:1333(D) and 22:1265(F) shall itemize and notify the insur…

A. Any homeowners policy of insurance that contains any provision that would apply more than one deductible to a loss resulting from any single incident covered by the policy shall be null and void and unenforceable as contrary to public policy.

A. If any Section or provision of Regulation 93 or the application to any person or circumstance is held invalid, such invalidity or determination shall not affect other Sections or provisions or the application of Regulation 93 to any persons or circumstances that can be given e…

A. Regulation 93 shall become effective upon final publication in the Louisiana Register.

A. As used in this Chapter, the following terms shall, unless the context clearly requires otherwise, have the following meanings: CDC—the Centers for Disease Control and Prevention, U.S. Department of Health and Human Services CDC Guidelines—with respect to PrEP, means the guide…

A. This statewide protocol establishes the rules a Louisiana-licensed pharmacist (“pharmacist”) shall follow to dispense and/or administer pre-exposure and post-exposure prophylaxis medications for the prevention of HIV infection pursuant to Act 711 of 2024 (R.S. 37:1218.2). B. P…

A. Prior to dispensing and/or administering HIV prevention medication per this protocol, the pharmacist must: 1. hold a current pharmacy license that is in good standing to practice in the state of Louisiana; 2. be a current practicing pharmacist; 3. have earned a Doctor of Pharm…

A. Pharmacists shall maintain a patient record for all services and treatments dispensed and/or administered under this protocol. B. If the patient provides written consent to do so, a process shall be in place for the pharmacist to communicate with the patient's primary care pro…

A. Training Content. Prior to independently dispensing and/or administering HIV prevention therapies to a patient pursuant to R.S. 37:1218.2, the pharmacist shall successfully complete a training program approved by the Accreditation Council for Pharmacy Education (ACPE). This tr…

A. Under this protocol, pharmacists may assess for HIV status and high-risk behaviors in which pre-exposure prophylaxis against HIV would be warranted. B. The pharmacist may dispense and/or administer the patient a 30-day supply of any antiretroviral agent that is a currently FDA…

A. Post-Exposure Prophylaxis (PEP) is the use of antiretroviral drugs after a single high-risk event to decrease the risk of HIV seroconversion. PEP must be started as soon as possible to be effective and always within 72 hours of the possible exposure. B. Under this protocol, ph…

A. Pharmacists shall document a focused assessment of the patient’s eligibility for HIV PrEP/PEP following best practices and guidelines for preventing HIV according to CDC Guidelines. B. Pharmacists shall document the patient’s written consent for HIV PrEP/PEP-related testing, c…

A. Pharmacists shall refer patients with reactive HIV, STI, or Hepatitis B or C tests to an appropriate care provider for confirmatory testing and follow-up care as applicable and provide the patient with written information about appropriate providers and clinics in their desire…

A. All health coverage plans, third-party administrators, and pharmacy benefit managers operating within the state of Louisiana shall establish the process for pharmacists to enroll as providers for the purposes of dispensing and/or administering HIV PrEP and/or PEP, equivalent t…

A. The Louisiana Department of Health will issue a standing order in compliance with and under the authority of R.S. 37:1218.2 which shall be deemed a medical order for any FDA-approved or CDC-recommended HIV PrEP or PEP therapy, as long as all conditions of the statewide protoco…

A. Except as otherwise provided under this Title, these laboratory fees shall not be charged: 1. to the Office of Public Health of the Louisiana Department of Health (LDH) or for laboratory services for a patient at a clinic or health unit operated by the Office of Public Health …

A. The fees shall be billed to the submitter as follows. 1. A submitter who meets the definition of a billable submitter and wishes to contract with the Division of Laboratories (DOL) to provide one or more of the laboratory tests described in the fee schedule should contact the …

A. The New Opportunities Waiver (NOW), hereafter referred to as the NOW, is designed to enhance the home and community-based services and supports available to individuals with developmental disabilities, who would otherwise require an intermediate care facility for persons with …

A. NOW beneficiaries are expected to be integrated in and have full access to the greater community while receiving services, to the same extent as individuals without disabilities. Providers shall meet the requirements of the U.S. Department of Health and Human Services, Centers…

A. In order to qualify for the New Opportunities Waiver (NOW), an individual must be three years of age or older and meet all of the following criteria: 1. have an intellectual and/or developmental disability as specified in R.S. 28:451.2; 2. be deemed eligible for developmental …

A. A uniform needs-based assessment in conjunction with person-centered planning is utilized in the service planning process for the individuals receiving or participating in an OCDD waiver. The results of this assessment activity shall be utilized to determine which OCDD waiver …

A. Individuals shall be denied admission to or discharged from the NOW if one of the following criteria is met: 1. the individual does not meet the financial eligibility requirements for the Medicaid Program; 2. the individual does not meet the requirement for an ICF-IDD level of…

A. The resource allocation model shall be used to assign service units based on the findings of the needs-based assessment and person-centered planning discussion for individuals who will be offered or are currently receiving New Opportunities Waiver services. Within the resource…

A. The intellectual/developmental disabilities request for services registry, hereafter referred to as “the registry,” is the list that documents and maintains the person’s name and protected request date for waiver services. A person’s protected request date for any OCDD waiver …

A. When used in this Subpart, unless expressly stated otherwise or unless the context of subject matter requires a different interpretation: Departmentthe Louisiana Department of Health and Hospitals. Home Based Caremedical, hospice, and support services provided in the client's …

A. All services provided under this program are to be performed in the home for HIV infected clients at a physician's order. Visits are limited to a maximum of once a day unless otherwise indicated. B. Home Based Care 1. Skilled nursing including but not limited to: a. medication…

A. Client must be HIV infected and require medical and/or nursing intervention. B. Client desires home based care as determined and documented by the social worker/case manager, and client's primary care physician. C. Service is not covered by any other third-party coverage. This…

A. Agency is licensed home health care or hospice provider. B. Agency will confirm client's eligibility for the program as stated above before the initiation of care. If an agency initiates care prior to eligibility confirmation, it will be financially responsible for care for cl…

A. A client can be recommended for home based care services by the physician, nurse, social worker, or case manager involved with the client's care. Client's eligibility must be verified by the service agency and verification provided to the department. Written orders for home ba…

A. Eligibility for services under this program will be terminated if the client: 1. subsequently is determined to have a household income greater than 200 percent of the federal poverty line; 2. subsequently is determined to have assets of greater than $4,000; 3. is not stable en…

A. Agencies will submit invoices for services provided as required. Agencies will provide individual client service utilization reports as required under the Ryan White Uniform Reporting System. All eligibility forms and the signed plan of treatment are to be submitted within 48 …

A. Persons requesting and denied services under this program are entitled to request a conference and/or fair hearing to review the decision of the service agency.

A. Payment for home based care services delivered under this program will be made directly to the service agency.

The confidentiality of HIV and AIDS related information is required in accordance with R.S. 40:38.5. Each disclosure of confidential HIV-related information must be accompanied by the appropriate release.