Senate Bill No. 363, introduced by Senator Barrow, aims to enhance health insurance coverage by enacting R.S. 22:1128.1. This new provision prohibits health insurance issuers from substituting a lower level of care for medically necessary treatments when such a substitution contradicts the recommendations of the treating provider and is primarily motivated by cost-containment or utilization management criteria that do not align with generally accepted standards of care. The bill defines "lower level of care" as any healthcare service or setting that offers less intensive treatment than what the treating provider recommends.

Additionally, the bill includes a provision that allows for exceptions if the alternative level of care is consistent with generally accepted medical practices and is clinically appropriate for the patient's condition. This legislation is set to take effect on August 1, 2026, and aims to ensure that patients receive the appropriate level of care as determined by their healthcare providers, rather than being subjected to potentially inadequate alternatives based on cost considerations.