LOUISIANA SUMMARY OF EXISTING LAW

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 covered persons. A health insurance issuer shall not condition, deny, restrict, refuse to authorize or approve, or reduce payment to a participating provider for a physician-administered drug when all criteria for medical necessity are met, because the participating provider obtains physician-administered drugs from a pharmacy that is not a participating provider in the health insurance issuer’s network. However, nothing shall prohibit a health insurance issuer or its agent from establishing differing copayments or other cost-sharing amounts within the benefit plan for covered persons who acquire physician-administered drugs from other providers. The commission of any act prohibited by this Part shall be considered an unfair method of competition and unfair practice.

Links to Proposed Laws: LA R.S. 22:1020.51

Provides a near prohibition of requiring physicians or providers to accept white-bagged or brown-bagged prescriptions, when they can administer such medications themsleves, subject to certain medical standards. Also provides private enforcement mechanisms when PBMs violate these rules.