Recently, Gov. Bel Edwards signed numerous healthcare bills into law.
Act 336 (previously HB 41) requires a health plan to pay for covered occupational therapy services provided via telehealth equivalent to the coverage and payment for the same service provided in person. Generally, the new law's provisions prohibit coverage maximums, cost-sharing, and other conditions relative to telehealth services that are inapplicable to in-person services.
Act 299 (previously HB 186), known as "The Medically Necessary Fertility Preservation Act," requires health plans to cover medically-necessary expenses for standard fertility preservation services when a medically necessary treatment may directly or indirectly cause iatrogenic infertility. Iatrogenic infertility is a fertility impairment caused by surgery, chemotherapy, radiation or other medical treatment. Coverage for standard fertility preservation services includes costs associated with storing oocytes and sperm for certain periods. The plan cannot require preauthorization; however, certain cost-sharing and maximum benefit limitations are permitted.
Under Act 270 (previously HB 272), a health plan that provides benefits for maternity services must include coverage for maternity support services provided by a doula to pregnant and birthing women before, during and after childbirth. A doula is an individual who has been trained to provide physical, emotional, and educational support, but not medical or midwifery care, to pregnant and birthing women and their families.
The new law also requires health plans to provide up to two months of coverage for medically necessary pasteurized donor human milk as prescribed by an infant's pediatrician due to certain conditions.
Act 281 (previously HB 578) requires a health plan to include coverage for smoking cessation benefits for a minimum period of six months if a licensed physician recommends and certifies that the smoking cessation benefits may help the person to quit smoking. Smoking cessation benefits means smoking cessation treatments and services, including individual counseling, group counseling, nicotine patches, nicotine gum, nicotine lozenges, nicotine nasal spray, nicotine inhaler, and the medications bupropion and varenicline. The required coverage cannot be subject to annual deductibles, coinsurance, copayment, or any other out-of-pocket or cost-sharing expense provisions.
Under Act 324 (previously SB 104), a health plan must cover biomarker testing for purposes of the diagnosis, treatment, appropriate management or ongoing monitoring of an individual's disease or condition when such testing is supported by certain medical and scientific evidence. Biomarker testing is used in cancer treatment and involves the analysis of an individual's tissue, blood or other biospecimens for the presence of a gene mutation or other characteristic that can be evaluated to assess how an individual may respond to a particular course of therapy. The coverage can be subject to annual deductibles and cost-sharing.
Plans are not required to cover biomarker testing for screening purposes.
Generally, the above new laws apply to health policies and plans issued or delivered in the state on and after January 1, 2024. Additionally, any health policy or plan in effect prior to January 1, 2024, is required to conform to these new laws on or before the renewal date but no later than January 1, 2025.
Employers should be aware of these coverage updates and contact their carriers for further information.