Bill > HB467

This bill requires health insurance providers and Medicaid in Louisiana to cover amino acid-based elemental formulas for children two years old and younger under specific medical conditions. The coverage applies when a board-certified allergist or gastroenterologist diagnoses a child with certain medical conditions, including immunoglobulin E and non-immunoglobulin E mediated allergies to multiple food proteins, severe food protein-induced enterocolitis syndrome, eosinophilic disorders confirmed by biopsy, or impaired nutrient absorption due to gastrointestinal tract disorders. The bill mandates that this coverage be provided on the same basis as prescription drugs, potentially subject to standard deductibles, copayments, and coinsurance. Insurance providers and Medicaid organizations can conduct utilization reviews to assess the medical necessity of the formula, but must provide coverage when a treating physician determines it is medically necessary. The legislation is known as the "Darcy Evelyn Bivins Act" and will apply to new insurance policies issued after the January first following the bill's effective date, with existing policies required to conform within 359 days. The bill's implementation is contingent on specific legislative appropriation of funds.