THE CONSTITUTION DOES NOT CONFER A RIGHT TO ABORTION; ROE AND CASEY ARE OVERRULED; AND THE AUTHORITY TO REGULATE ABORTION IS RETURNED TO THE PEOPLE AND THEIR ELECTED REPRESENTATIVES.
ANTI-TRUST PROTECTIONS GET CONTROVERSIAL.
Rep. Barry Ivey’s amendment requires the Louisiana Department of Health to promulgate rules establishing an exclusive list of anomalies, diseases, disorders and other conditions to be deemed medically futile. [NOTE: As this edition of the Journal is going to press, LSMS is reviewing the Supreme Court’s decision. We will be working with other groups to provide a more comprehensive report specific to this issue in a supplement.]
SB 276 by Senate Insurance Committee Chairman Kirk Talbot started as a “placeholder” bill but was amended during its committee hearing to become one of the most controversial bills of the session. As amended, it exempted all managed care organizations from any provision of the law including Louisiana anti-trust statutes. It also included retroactive language which would have removed Louisiana’s largest health insurer from a lawsuit currently moving through the courts. The bill failed to pass by a vote of 14 to 20. The author gave notice of reconsideration which allowed it to be considered for a second vote at a later date. Despite intense lobbying efforts to pass the bill and amendments to address concerns of legislators, the insurance companies fell one vote short.
RELIEVING BURDENS.
On the positive side of the equation, LSMS and other groups did successfully work together on and pass a package of bills aimed at easing administrative burdens. Additional details on the bills provided on pages 20 and 21. Act 432 (SB 112) by Sen. Robert Mills mirrored the Texas “gold card” bill and would have provided relief from prior authorizations in certain circumstances. Despite compelling testimony from physicians and amendments requested by the insurance companies, the Senate Insurance Committee was not inclined to report the bill as written. When reported, the bill had been amended to require each insurance company to develop and post its own version of prior authorization relief for providers. While this is a unique step forward, we remain committed to bringing legislation in the future if this does not provide you with results. Act 166 (HB 339) by Rep. JP Coussan focuses on coordination of benefits and prohibits health plans from pending, delaying, or denying payment to a provider on the basis of the insured’s failure to provide notice of another insurance policy. SB 59 by Sen. Fred Mills and Rep. Larry Bagley prohibits a Medicaid MCO from requiring any enrolled providers to participate in a prepayment review unless the review is implemented directly by the Louisiana Department of Health and is in accordance with the provisions of the Medical Assistance Programs Integrity Law. Act 143 (HB 286) by Rep. Chris Turner stipulates that any healthcare provider who maintains hospital privileges or is a member of a hospital medical staff with a licensed hospital shall be considered to have satisfied and shall otherwise be exempt from having to satisfy any credentialing requirements of a Medicaid managed care organization. ■
ABORTION AND LOUISIANA TRIGGER LAWS.
On June 24, 2022, the US Supreme Court released its opinion in Dobbs v. Jackson. The ruling overturned Roe v. Wade and held, “The Constitution does not confer a right to abortion; Roe and Casey are overruled; and the authority to regulate abortion is returned to the people and their elected representatives.” Until this ruling, Roe v. Wade which was decided in 1973 governed policies related to abortion. Thus, any discussions regarding restrictions on elective abortions in Louisiana (and elsewhere) had been largely hypothetical. Now, the conversation is very real. Louisiana has had “trigger laws” on the books for years (laws that would only go into effect if Roe were overturned or a change occurred at the federal level allowing the states authority to further restrict abortion). Sen. Katrina Jackson passed SB 342 during the session which creates mandatory imprisonment and fines for physicians who perform elective pregnancy terminations in most circumstances. Physician advocates worked throughout the legislative process to tighten language that was considered unclear and to add an exception for a medically futile pregnancy. While the author did not support this effort, she did not fight the will of the legislature in providing both clarity and the additional exception. Other exceptions include life or serious bodily injury to the mother and both the removal of and use of methotrexate for ectopic pregnancies. A number of amendments were proposed and failed, including an exception for rape and incest. Unfortunately, on the House floor during debate, language was adopted that added another layer of complexity.
18 J LA MED SOC | VOL 174 | SUMMER 2022
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