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0 chapters · 1,747 sections in this title.
La. Rev. Stat. § 22:1 Louisiana Insurance Code
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§1. Louisiana Insurance Code This Title shall be known and may be cited as the "Louisiana Insurance Code". Acts 1958, No. 125; Acts 1993, No. 664, §1; Acts 2003, No. 135, §1.
La. Rev. Stat. § 22:1000 Group, family group, blanket, and association health and accident insurance
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§1000. Group, family group, blanket, and association health and accident insurance A. Any insurer authorized to write health and accident insurance in this state shall have the power to issue policies described in this Section, provided that no policy issued pursuant to this Sect…
La. Rev. Stat. § 22:1001 Mandatory coverage and continued coverage of children with physical or mental disabilities of insured
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§1001. Mandatory coverage and continued coverage of children with physical or mental disabilities of insured A. Any hospital or medical expense insurance policy delivered or issued for delivery in this state more than ninety days after July 2, 1973, which provides that coverage o…
La. Rev. Stat. § 22:1003 Coverage of children for group and individual health and accident insurance; exception
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§1003. Coverage of children for group and individual health and accident insurance; exception A.(1) Children, including a grandchild in the legal custody of and residing with a grandparent, until the age of twenty-six shall be considered as dependents of the primary insured or en…
La. Rev. Stat. § 22:1003.1 Children; portability; enrollment; exception
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§1003.1. Children; portability; enrollment; exception A. In reference to R.S. 22:1003, the following shall apply: (1) The health insurance issuer or health maintenance organization shall apply portability rights in reference to preexisting conditions to the newly added child or g…
La. Rev. Stat. § 22:1004 Insurance pending adoption
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§1004. Insurance pending adoption A. Any unmarried child who is placed in the home of an insured pursuant to an adoption placement agreement executed with an adoption agency licensed in accordance with the Child Care Facility and Child-Placing Agency Licensing Act, R.S. 46:1401 e…
La. Rev. Stat. § 22:1005 Continuity of care of health care services
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§1005. Continuity of care of health care services A. For purposes of this Subsection: (1) "Covered health care services" means services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease that are…
La. Rev. Stat. § 22:1006 Health benefit plans; replacement; continuance of benefits
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§1006. Health benefit plans; replacement; continuance of benefits A. This Section shall apply to any health benefit plan that provides coverage to two or more employees of an employer in this state if any of the following conditions is satisfied: (1) Any portion of the premium or…
La. Rev. Stat. § 22:1006.1 Prior authorization forms required; criteria
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§1006.1. Prior authorization forms required; criteria A. As used in this Section: (1) "Health benefit plan", "plan", "benefit", or "health insurance coverage" means services consisting of medical care, provided directly, through insurance or reimbursement, or otherwise, and inclu…
La. Rev. Stat. § 22:1007 Requirements of provider contracts; communications
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§1007. Requirements of provider contracts; communications A. As used in this Section, the following definitions shall apply: (1) "Enrollee", "prospective enrollee", or "patient" means an individual, his spouse, and any dependent, if any, who is enrolled in a health maintenance or…
La. Rev. Stat. § 22:1008 Health and accident policy provisions; provider contracts; prohibited incentives
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§1008. Health and accident policy provisions; provider contracts; prohibited incentives A. No hospital or medical service contract, health and accident policy, or any other insurance contract of this type shall include provisions which include an incentive or specific payment mad…
La. Rev. Stat. § 22:1009 Health care provider credentialing
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§1009. Health care provider credentialing A. As used in this Section, the following words and phrases have the following meanings ascribed for each, unless the context clearly indicates otherwise: (1) "Applicant" means a health care provider seeking to be approved or credentialed…
La. Rev. Stat. § 22:1010 Discrimination against volunteer firemen prohibited
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§1010. Discrimination against volunteer firemen prohibited No insurer doing business in this state who issues an individual or a group policy of hospitalization or major medical coverage to an insured who is a volunteer fireman shall charge a higher premium rate for the insured b…
La. Rev. Stat. § 22:1011 Employer-provided health plan; limitation to specific pharmacies prohibited; penalty
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§1011. Employer-provided health plan; limitation to specific pharmacies prohibited; penalty A. No employer who provides pharmacy services including prescription drugs to any employee or retiree of such employer, as part of any health insurance or health maintenance program, shall…
La. Rev. Stat. § 22:1012 Cancellation prohibited after claim for terminal, incapacitating, or debilitating condition
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§1012. Cancellation prohibited after claim for terminal, incapacitating, or debilitating condition A. No group, individual, family group, or blanket health insurer shall unilaterally cancel a policy after the insurer has received any covered claim or notice of any covered claim f…
La. Rev. Stat. § 22:1013 Local government contributions toward medical savings accounts, health savings accounts, and similar accounts
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§1013. Local government contributions toward medical savings accounts, health savings accounts, and similar accounts Notwithstanding any other provision of law to the contrary, the governing authority of any parish, municipality, or other political subdivision of the state may es…
La. Rev. Stat. § 22:1014 Limitations on health insurance coverage of elective abortions in the state exchange
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§1014. Limitations on health insurance coverage of elective abortions in the state exchange prohibited A. The legislature finds and declares all of the following: (1) Federal funding for insurance plans that cover abortions is prohibited by the Hyde Amendment and the Federal Empl…
La. Rev. Stat. § 22:1015 Exemption of proceeds; health and accident
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§1015. Exemption of proceeds; health and accident The proceeds or avails of all contracts of health and accident insurance and of provisions providing benefits on account of the insured's disability which are supplemental to life insurance or annuity contracts effected shall be e…
La. Rev. Stat. § 22:1016 Regulation by the Department of Insurance and the Louisiana Department of Health
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§1016. Regulation by the Department of Insurance and the Louisiana Department of Health of prepaid entities participating in the Louisiana Medicaid Program A. Notwithstanding any law to the contrary, any prepaid entity that participates in the Louisiana Medicaid Program is requir…
La. Rev. Stat. § 22:1017 Wellness or health improvement programs
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§1017. Wellness or health improvement programs A. A health insurance issuer may offer a voluntary wellness or health improvement program that allows for rewards or incentives including but not limited to merchandise, gift cards, debit cards, premium discounts or rebates, contribu…
La. Rev. Stat. § 22:1018 Choice in obtaining health insurance coverage
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§1018. Choice in obtaining health insurance coverage A. It is hereby declared that the public policy of this state, consistent with our constitutionally recognized and inalienable right of liberty, is that every person within this state is and shall be free from governmental intr…
La. Rev. Stat. § 22:1019.1 Short title; purpose; scope; definitions
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§1019.1. Short title; purpose; scope; definitions A. This Subpart shall be known and may be cited as the "Network Adequacy Act". B. The purpose and intent of this Subpart is to establish standards for the creation and maintenance of networks by health insurance issuers and to ens…
La. Rev. Stat. § 22:1019.2 Network adequacy
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§1019.2. Network adequacy A. A health insurance issuer providing a health benefit plan shall maintain a network that is sufficient in numbers and types of healthcare providers to ensure that all healthcare services to covered persons will be accessible without unreasonable delay.…
La. Rev. Stat. § 22:1019.3 Enforcement provisions; penalties; regulations
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§1019.3. Enforcement provisions; penalties; regulations A. If the commissioner determines that a health insurance issuer has not contracted with enough participating providers to ensure that covered persons have accessible health care services in a geographic area, that a health …
La. Rev. Stat. § 22:1020.1 Short title; purpose; scope; definitions
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§1020.1. Short title; purpose; scope; definitions A. This Subpart shall be known and may be cited as the "Network Provider Directory Accessibility and Accuracy Act". B. The purpose and intent of this Subpart is to establish standards for the creation and maintenance by a health i…
La. Rev. Stat. § 22:1020.2 Provider directory; content; accessibility
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§1020.2. Provider directory; content; accessibility A. A health insurance issuer shall maintain a directory of the issuer's network of providers on the internet. B. The directory shall include the name, specialty, if any, street address, and telephone number of each healthcare pr…
La. Rev. Stat. § 22:1020.3 Continuous review required
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§1020.3. Continuous review required A. A health insurance issuer shall conduct an ongoing review of the issuer's provider directory and correct or update the information as necessary. Except as provided in Subsections B and C of this Section, corrections and updates, if any, shal…
La. Rev. Stat. § 22:1020.4 Reporting of inaccurate information
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§1020.4. Reporting of inaccurate information A. A health insurance issuer shall conspicuously display in the issuer's provider directory an email address, a toll-free telephone number, or another mechanism that is easily accessible to any individual by which the individual may re…
La. Rev. Stat. § 22:1020.5 Investigation by the commissioner; assessment; penalties; applicability
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§1020.5. Investigation by the commissioner; assessment; penalties; applicability A. If, in any thirty-day period, a health insurance issuer receives three or more reports that allege the issuer's directory inaccurately represents a healthcare provider's network participation stat…
La. Rev. Stat. § 22:1020.51 Purpose and intent
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§1020.51. Purpose and intent The purpose and intent of this Subpart is to ensure patient access to physician-administered drugs and related services furnished to persons covered under a health insurance contract. This Subpart shall ensure that health insurance issuers do not inte…
La. Rev. Stat. § 22:1020.52 Definitions
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§1020.52. Definitions For purposes of this Subpart, the following words shall have the following meanings: (1) "Covered person" shall have the same meaning as provided in R.S. 22:1019.1. (2) "Health insurance issuer" shall have the same meaning as provided in R.S. 22:1019.1. (3) …
La. Rev. Stat. § 22:1020.53 Physician-administered drugs; access; payment
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§1020.53. Physician-administered drugs; access; payment A.(1) A health insurance issuer, pharmacy benefit manager, or their agent shall not refuse to authorize, approve, or pay a participating provider for providing covered physician-administered drugs and related services to cov…
La. Rev. Stat. § 22:1020.6 Printed form available upon request
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§1020.6. Printed form available upon request The directory of network providers required pursuant to this Subpart shall be furnished in printed form to any covered person upon request. Acts 2018, No. 290, §1, eff. Jan. 1, 2019.
La. Rev. Stat. § 22:1020.61 Selective application of prior authorization
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§1020.61. Selective application of prior authorization A.(1) Every health insurance issuer authorized to do business in this state shall implement and maintain a program that allows for the selective application of reducing prior authorization requirements that are based on the s…
La. Rev. Stat. § 22:1020.62 Utilization review reports; definitions
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§1020.62. Utilization review reports; definitions A. For purposes of this Section, the following terms have the following meanings: (1) "Health coverage plan" means any hospital, health, or medical expense insurance policy, hospital or medical service contract, employee welfare b…
La. Rev. Stat. § 22:1021 Prohibition of discrimination against dental care services
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§1021. Prohibition of discrimination against dental care services A. Whenever the terms "physician", "surgeon", "medical doctor", or any other terms which refer to licensed practitioners of the healing arts are used in any health and accident insurance policy, group health and ac…
La. Rev. Stat. § 22:1022 Prohibited discrimination; prenatal test results
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§1022. Prohibited discrimination; prenatal test results A. No hospital, health, or medical expense insurance policy, hospital or medical service contract, employee welfare benefit plan, health and accident insurance policy, or any other insurance contract of this type, including …
La. Rev. Stat. § 22:1023 Prohibited discrimination; genetic information; disclosure requirements; definitions
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§1023. Prohibited discrimination; genetic information; disclosure requirements; definitions A. As used in this Section, the following terms shall have the following meanings: (1) "Collection" means obtaining a DNA sample or samples. (2) "Compulsory disclosure" means any disclosur…
La. Rev. Stat. § 22:1023.1 Prohibited discrimination; potential organ transplant recipients with disabilities
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§1023.1. Prohibited discrimination; potential organ transplant recipients with disabilities A. For purposes of this Section, the following terms have the meaning ascribed to them in this Subsection: (1) "Anatomical gift" means a donation of all or part of a human body that takes …
La. Rev. Stat. § 22:1023.2 Coverage of a living donor; prohibitions
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§1023.2. Coverage of a living donor; prohibitions A. As used in this Section, the following terms apply: (1) "Insurance coverage" means coverage under a disability income, life, or long-term care insurance policy. (2) "Living donor" means an individual for which both of the follo…
La. Rev. Stat. § 22:1024 Group, family group, blanket, and association health and accident insurance; mandatory coverage
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§1024. Group, family group, blanket, and association health and accident insurance; mandatory coverage A. Any policy issued under this Section, which in addition to covering the insured also covers members of the insured's immediate family, shall provide coverage for illnesses an…
La. Rev. Stat. § 22:1025 Group, blanket, and association health insurance, treatment for alcoholism and drug abuse
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§1025. Group, blanket, and association health insurance, treatment for alcoholism and drug abuse A. Any group, blanket, or association health insurance policy issued under R.S. 22:1000 shall include as an option to be exercised by the policyholder, as defined therein, covered ben…
La. Rev. Stat. § 22:1025.1 Health insurance policies; mandated offering for treatment of lymphedema
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§1025.1. Health insurance policies; mandated offering for treatment of lymphedema A. Any health insurance policy issued or issued for delivery in this state shall include as an option to be exercised by the policyholder, as defined therein, covered benefits for the treatment of l…
La. Rev. Stat. § 22:1026 Group, family group, blanket, and association health and accident insurance; cleft lip and cleft palate coverage; mandatory coverage
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§1026. Group, family group, blanket, and association health and accident insurance; cleft lip and cleft palate coverage; mandatory coverage A. Any hospital, health, or medical expense insurance policy, hospital or medical service contract, employee welfare benefit plan, health an…
La. Rev. Stat. § 22:1027 Interpreter services for the deaf and hard of hearing; expenses
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§1027. Interpreter services for the deaf and hard of hearing; expenses A. Any hospital or medical expense insurance policy delivered or issued for delivery in this state on or after December 1, 1991, shall contain a provision or endorsement requiring payment for expenses incurred…
La. Rev. Stat. § 22:1028 Early screening and detection requirements; examination; coverage
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§1028. Early screening and detection requirements; examination; coverage A.(1) Any health coverage plan which is delivered or issued for delivery in this state shall include benefits payable for an annual Pap test and minimum mammography examination as provided in this Subsection…
La. Rev. Stat. § 22:1028.1 Required coverage for breast and ovarian cancer susceptibility screening
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§1028.1. Required coverage for breast and ovarian cancer susceptibility screening A. The legislature hereby finds that a woman's lifetime risk of developing breast or ovarian cancer is greatly increased if she inherits a harmful mutation in the BRCA1 or BRCA2 genes. Testing for t…
La. Rev. Stat. § 22:1028.2 Required coverage for diagnostic imaging
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§1028.2. Required coverage for diagnostic imaging A.(1) Any health coverage plan delivered or issued for delivery in this state shall include coverage for diagnostic imaging at the same level of coverage provided for the minimum mammography examination pursuant to R.S. 22:1028. (…
La. Rev. Stat. § 22:1028.3 Required coverage for genetic testing for cancer
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§1028.3. Required coverage for genetic testing for cancer A. The legislature hereby finds that cancer is a leading cause of death in this state. Medical advances in genetic testing for various types of cancer including but not limited to breast, ovarian, colon, thyroid, prostate,…
La. Rev. Stat. § 22:1028.4 Required coverage for genetic testing for critically ill infants
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§1028.4. Required coverage for genetic testing for critically ill infants A. The legislature hereby finds that employing the most comprehensive diagnostic testing available using advanced molecular techniques including but not limited to traditional whole genome sequencing, rapid…
