The bill, enacted as R.S. 22:1042.1, mandates that all health coverage plans in Louisiana provide coverage for medically necessary treatment related to acquired brain injuries, effective January 1, 2027. This coverage must not impose any lifetime or unreasonable annual limitations on treatment sessions and must be clearly stated by the health coverage plan issuer. Additionally, the bill prohibits health plans from imposing higher deductibles or out-of-pocket costs for these treatments compared to other similar benefits. It also ensures that coverage cannot be denied based solely on the treatment setting, as long as it meets clinical appropriateness and regulatory requirements.

The legislation outlines specific definitions related to acquired brain injuries and the types of medically necessary treatments that must be covered, including various forms of rehabilitation and therapy. It establishes a process for expedited appeals of adverse determinations made by health coverage plan issuers regarding treatment coverage. Furthermore, the bill clarifies that any provisions requiring the state to make payments under federal law will not exceed the essential health benefits specified in federal regulations. Existing policies will need to conform to these new requirements by their renewal date, but no later than January 1, 2028.