Senate Bill No. by Senator Barrow amends R.S. 22:1047(B) to enhance coverage for severe obesity treatment by introducing new requirements for health insurance issuers in Louisiana. The bill mandates that, starting August 1, 2026, insurers offering qualified health plans must submit annual cost estimates for providing required benefits for the year 2028 and beyond. Additionally, the Louisiana Department of Insurance is tasked with publishing an estimated cost for the state to cover these services by December 1, 2026, and notifying health insurance issuers of the funding ratio and minimum coverage standards by July 1, 2027.

The bill also establishes guidelines for the application of numerical caps on services related to severe obesity treatment. If the funding ratio meets or exceeds 1.0 in any plan year starting January 1, 2028, insurers cannot impose a numerical cap on services. Conversely, if the funding ratio is below 1.0, a cap may be applied, but it must be clearly stated in the health insurance plan documents using actual numerical values rather than formulas. This legislation aims to ensure comprehensive coverage for severe obesity treatment while providing transparency and accountability in cost management.

Statutes affected:
SB464 Original: 22:1047(B)