LEGISLATIVE FISCAL OFFICE
Fiscal Note
Fiscal Note On: HB 392 HLS 24RS 335
Bill Text Version: ENROLLED
Opp. Chamb. Action:
Proposed Amd.:
Sub. Bill For.:
Date: May 31, 2024 2:19 PM Author: FREEMAN
Dept./Agy.: LDH
Subject: Medicaid coverage Analyst: Shawn Hotstream
MEDICAID EN NO IMPACT See Note Page 1 of 1
Provides relative to Medicaid and private insurance coverage for perimenopausal and menopausal care
Proposed law provides for Medicaid coverage of hormonal care for any woman who is experiencing menopausal or
perimenopausal symptoms. Proposed law defines symptoms. The department shall cover inpatient and outpatient coverage
for perimenopausal or menopausal treatment when such care is used for a medically accepted indication and administered in
any healthcare facility by any healthcare professional appropriately licensed in the state to provide such medical treatment.
The eligibility of a prospective enrollee shall be determined by the healthcare facility providing the care.
Proposed law requires a health insurance issuer offering health coverage plans in the state to provide coverage for expenses
incurred for medically necessary menopausal or perimenopausal treatment. A health insurance issuer shall not require a
prior authorization or otherwise subject to a step-therapy or fail first policy or protocol for the administration or prescription
of any medication administered or prescribed for hormone replacement therapy used to treat symptoms of menopause and
perimenopause.
EXPENDITURES 2024-25 2025-26 2026-27 2027-28 2028-29 5 -YEAR TOTAL
State Gen. Fd. $0 $0 $0 $0 $0 $0
Agy. Self-Gen. $0 $0 $0 $0 $0 $0
Ded./Other $0 $0 $0 $0 $0 $0
Federal Funds $0 $0 $0 $0 $0 $0
Local Funds $0 $0 $0 $0 $0 $0
Annual Total $0 $0 $0 $0 $0 $0
REVENUES 2024-25 2025-26 2026-27 2027-28 2028-29 5 -YEAR TOTAL
State Gen. Fd. $0 $0 $0 $0 $0 $0
Agy. Self-Gen. $0 $0 $0 $0 $0 $0
Ded./Other $0 $0 $0 $0 $0 $0
Federal Funds $0 $0 $0 $0 $0 $0
Local Funds $0 $0 $0 $0 $0 $0
Annual Total $0 $0 $0 $0 $0 $0
EXPENDITURE EXPLANATION
Information provided by the Office of Group Benefits indicates all five of their self-funded health plans already provide
coverage for medically necessary perimenopausal and menopausal care. However, a provision of this measure removes
prior authorization or step therapy protocols for any medication administered or prescribed for hormone replacement
therapy used to treat symptoms of menopause. The LFO is waiting on a response from OGB relative to this provision of the
bill potentially impacting premium rate adjustments.
There is no anticipated direct material effect on Medicaid expenditures as a result of this measure. The Louisiana Department
of Health (LDH) indicates Medicaid currently covers such services based on medical necessity. Medicaid covers treatments
(non-hormonal treatments, hormonal treatments with a prior authorization, prescription medications, preventive care,
counseling, and support) for menopausal and perimenopausal symptoms. Medicaid does not cover
experimental/investigational drugs, procedures, or equipment, nor assisted reproductive technology for the treatment of
infertility or decreased fertility.
REVENUE EXPLANATION
There is no anticipated direct material effect on governmental revenues as a result of this measure.
Senate Dual Referral Rules House
13.5.1 >= $100,000 Annual Fiscal Cost {S & H} 6.8(F)(1) >= $100,000 SGF Fiscal Cost {H & S}
Patrice Thomas
13.5.2 >= $500,000 Annual Tax or Fee 6.8(G) >= $500,000 Tax or Fee Increase
Change {S & H} or a Net Fee Decrease {S} Deputy Fiscal Officer