Senate Bill No. 295, introduced by Senator Wheat, mandates that all health coverage plans in Louisiana provide coverage for medically necessary treatments related to acquired brain injuries, effective August 1, 2026. The bill prohibits any lifetime or unreasonable annual limitations on the number of treatment days or sessions, ensuring that limitations on inpatient rehabilitation services are distinct from those for post-acute rehabilitation. Additionally, it stipulates that coverage cannot impose greater deductibles, coinsurance, or out-of-pocket limits than other similar benefits within the health plan. The bill also ensures that coverage cannot be denied based solely on the treatment location, provided it meets clinical appropriateness and regulatory compliance.

The legislation outlines that any adverse determinations regarding treatment must be made by a clinical peer reviewer and establishes a process for expedited appeals of such determinations. It specifies that treatments must be delivered by qualified practitioners and facilities, and it defines key terms related to acquired brain injuries and necessary treatments. The provisions apply to new policies issued on or after January 1, 2027, with existing policies required to conform by their renewal date, but no later than January 1, 2028.