§1060.14. Requirement to cover services consistent with nationally recognized clinical
practice guidelines
A. No health coverage plan that is renewed, delivered, or issued for delivery in this
state that provides coverage for cancer in accordance with the Louisiana Insurance Code shall
deny a request for prior authorization or the payment of a claim for any procedure,
pharmaceutical, or diagnostic test typically covered under the plan to be provided or
performed for the diagnosis and treatment of cancer if the procedure, pharmaceutical, or
diagnostic test is recommended by nationally recognized clinical practice guidelines for use
in the diagnosis or treatment for the insured's particular type of cancer and clinical state.
B. The provisions of this Section shall not prohibit a health insurance issuer from
requiring utilization review to assess the effectiveness of the procedure, pharmaceutical, or
test for the insured's condition, but if the procedure, pharmaceutical, or test is what is
recommended by nationally recognized clinical practice guidelines for use in the diagnosis
or treatment for the insured's particular type of cancer and clinical state, then any associated
prior authorization shall be approved within the time limit specified in R.S. 22:1060.13.
Acts 2023, No. 254, §1.