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      RS 22:11     

  

SUBPART B. COMPLIANCE WITH CODE REQUIRED;

RULES AND REGULATIONS BY COMMISSIONER;

QUALIFICATION REQUIRED

§11. Rules and regulations by commissioner

            A. The commissioner of insurance may promulgate rules and regulations that the commissioner determines are necessary for implementation of this Title. Such implementation shall be subject to the legislative oversight of the House of Representatives and Senate committees on insurance in accordance with R.S. 49:966.

            B. In addition to any other powers granted by the Louisiana Insurance Code, the commissioner of insurance is hereby empowered to promulgate any rule or regulation necessary to meet the requirements for the accreditation of the Louisiana Department of Insurance under the National Association of Insurance Commissioners, Financial Regulation Standards and Accreditation Program. Such implementation shall be subject to the legislative oversight of the Senate and House committees on insurance in accordance with R.S. 49:966.

            C.(1) When the governor declares a state of emergency pursuant to R.S. 29:724 or a public health emergency pursuant to R.S. 29:766, the commissioner may issue emergency rules or regulations that address any of the following related to insurance policies or health maintenance organization contracts in this state:

            (a) Medical coverage relative to each of the following:

NOTE: Item (C)(1)(a)(i) eff. until Jan. 1, 2024. See Acts 2023, No. 322.

            (i) Removal of telehealth and telemedicine access restraints.

NOTE: Item (C)(1)(a)(i) eff. Jan. 1, 2024. See Acts 2023, No. 322.

            (i) Removal of telehealth access restraints.

            (ii) Suspension of physician credentialing requirements.

            (iii) Expansion of remote access to pharmaceutical drugs.

            (b) Grace periods for payment of premiums and performance of other obligations by insurers or insureds. For health and accident insurance and health maintenance organizations, the commissioner may implement a grace period not to exceed sixty days during which the commissioner shall be strictly limited to requiring health insurers to pend all subsequent claims until any arrearages are corrected or the product is permissibly cancelled or nonrenewed at the end of the grace period. The commissioner may require prior notice to providers as a prerequisite for nonpayment of claims. In the event arrearages are not corrected within the duration of the grace period and the product is permissibly cancelled or nonrenewed, a healthcare provider may seek payment for any medical services that were rendered by the healthcare provider but pended by the insurer directly from the insured.

            (c) Temporary postponement of involuntary cancellation or nonrenewal by the insurer.

            (2) An action pursuant to Paragraph (1) of this Subsection shall specify all of the following:

            (a) The kinds of insurance, as defined in R.S. 22:47, affected.

            (b) The geographic areas to which the emergency rule or regulation applies, which may be less extensive but shall not be more extensive than the geographic areas in the governor's emergency declaration.

            (c) The effective dates of the emergency rule or regulation, which shall not exceed the period of the governor's emergency declaration including any extensions or an earlier termination of the state of emergency.

            (3) Any emergency rules or regulations issued by the commissioner pursuant to this Subsection shall be subject to legislative oversight in accordance with R.S. 49:950 et seq. and all of the following:

            (a) If the commissioner finds that an imminent peril to the public health, safety, or welfare requires adoption of a rule upon shorter notice than that provided in R.S. 49:961(A) and within five days of adoption states in writing to the governor of the state of Louisiana, the attorney general of Louisiana, the speaker of the House of Representatives, the president of the Senate, and the office of the state register, the reasons for that finding, the commissioner may proceed without prior notice or hearing or upon any abbreviated notice and hearing that it finds practicable to adopt an emergency rule.

            (b) The commissioner's statement of the reasons for finding it necessary to adopt an emergency rule shall include specific reasons why the failure to adopt the rule on an emergency basis would result in imminent peril to the public health, safety, or welfare, or specific reasons why the emergency rule meets other criteria provided in this Subsection for adoption of an emergency rule.

            (c) The commissioner's statement required in this Paragraph shall be submitted to the speaker of the House of Representatives and the president of the Senate at their respective offices in the state capitol by electronic transmission if such means are available. If electronic means are not available, the commissioner's statement shall be submitted to the office of the speaker of the House of Representatives and the president of the Senate in the state capitol by certified mail with the return receipt requested or by messenger who shall provide a receipt for signature. The return receipt, the receipt for signature, or the electronic confirmation receipt shall be proof of receipt of the commissioner's statement by the respective offices.

            (d) Within sixty days after receipt of the commissioner's statement by the presiding officer of either house for an emergency rule, an oversight subcommittee of that house may conduct a hearing to review the emergency rule and make a determination of whether the emergency rule meets the criteria for an emergency rule and those determinations as provided in R.S. 49:966(D)(3). If within that time period an oversight subcommittee finds an emergency rule unacceptable, it shall prepare a written report containing a copy of the proposed rule and a summary of the determinations made by the committee and transmit copies thereof as provided in R.S. 49:966(F)(2).

            (e) Within sixty days after adoption of an emergency rule, the governor may review the emergency rule and make the determinations as provided in Subparagraph (d) of this Paragraph. If within this time period the governor finds an emergency rule unacceptable, he shall prepare a written report as provided in Subparagraph (d) of this Paragraph and transmit copies thereof to the commissioner and the Louisiana Register no later than four days after the governor makes his determination.

            (f) Upon receipt by the commissioner of a report as provided in either Subparagraph (d) or (e) of this Paragraph, the rule shall be nullified and shall be without effect.

            (g) Nothing in this Paragraph shall be construed to grant the commissioner authority to issue emergency rules or regulations not otherwise authorized by Paragraph (1) of this Subsection.

            (4) No later than June 30, 2021, the commissioner shall promulgate, in accordance with provisions of the Administrative Procedure Act, rules and regulations to govern the business of insurance in the event of a declaration of emergency. The rules and regulations promulgated by the commissioner shall establish requirements related to insurance policies or health maintenance contracts under the authority granted by Paragraph (1) of this Subsection.

            (5)(a) Any rule adopted pursuant to the authority granted in Subparagraph (1)(a) of this Subsection and governing medical coverage not specifically enumerated therein shall be presented by the commissioner to the Senate Insurance Committee and House Insurance Committee for review and approval by either committee prior to adoption.

            (b) Any temporary postponement of cancellation or nonrenewal pursuant to Subparagraph (1)(c) of this Subsection shall not remain in effect beyond sixty days unless presented by the commissioner to the Senate Insurance Committee and House Insurance Committee for review and approval by either committee prior to any extension.

            (c) The House Committee on Insurance and the Senate Committee on Insurance meeting jointly or separately to consider an emergency rule promulgated pursuant to this Subsection may reject the rule or any provision thereof, in which case the rejected rule or provision shall be nullified and shall be without effect.

            Acts 1958, No. 125; Acts 1979, No. 117, §1; Acts 1992, No. 463, §1; Redesignated from R.S. 22:3 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2009, No. 503, §1; Acts 2021, No. 223, §1; Acts 2023, No. 322, §1, eff. Jan. 1, 2024.

NOTE: Former R.S. 22:11 redesignated as R.S. 22:1824 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.



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