§1057. Coverage for COVID-19 tests and treatments
A.No health coverage plan delivered or issued for delivery in this state shall deny
coverage for COVID-19 diagnostic tests, antibody tests, and antiviral drugs when ordered
by a physician for the purpose of making clinical decisions or treating a patient suspected of
having COVID-19.
B.Any health coverage plan delivered or issued for delivery in this state shall
include coverage for COVID-19 diagnostic tests, antibody tests, and antiviral drugs in
accordance with this Section.
C.The coverage required in this Section shall not be subject to annual deductibles,
coinsurance, copayment, or any other out-of-pocket or cost-sharing expense provisions until
December 31, 2021. After December 31, 2021, these services may be subject to these cost-s
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§1057. Coverage for COVID-19 tests and treatments
A. No health coverage plan delivered or issued for delivery in this state shall deny
coverage for COVID-19 diagnostic tests, antibody tests, and antiviral drugs when ordered
by a physician for the purpose of making clinical decisions or treating a patient suspected of
having COVID-19.
B. Any health coverage plan delivered or issued for delivery in this state shall
include coverage for COVID-19 diagnostic tests, antibody tests, and antiviral drugs in
accordance with this Section.
C. The coverage required in this Section shall not be subject to annual deductibles,
coinsurance, copayment, or any other out-of-pocket or cost-sharing expense provisions until
December 31, 2021. After December 31, 2021, these services may be subject to these cost-sharing requirements.
D. For purposes of this Section, the following definitions apply:
(1) "COVID-19" means the coronavirus disease 2019 as designated by the World
Health Organization.
(2)(a) "COVID-19 antibody test" means a test that meets all of the following
requirements:
(i) Is fully approved or granted an Emergency Use Authorization by the United States
Food and Drug Administration (FDA).
(ii) Follows the Enzyme-Linked Immunosorbent Assay (ELISA) test methodology
performed in highly complex clinical laboratories and includes an antibody titer.
(iii) Is ordered by a physician for the purpose of determining the likelihood of a
previous infection.
(b) "COVID-19 antibody test" shall not include a test used for employment-related
or public health surveillance testing.
(3) "COVID-19 antiviral drug or agent" is a medication that is fully approved or
granted an Emergency Use Authorization by the FDA for the treatment or prevention of
COVID-19 infections when ordered by a physician.
(4) "COVID-19 diagnostic test" or "diagnosis test" means a test that is fully approved
or granted an Emergency Use Authorization by the FDA and is ordered by a physician for
the purpose of diagnosing an active infection or determining recovery from an active
infection. "COVID-19 diagnostic test" or "diagnosis test" shall not include a test used for
employment-related or public health surveillance testing.
(5) "Health coverage plan" means any hospital, health, or medical expense insurance
policy, hospital or medical service contract, employee welfare benefit plan, contract, or other
agreement with a health maintenance organization or a preferred provider organization,
health and accident insurance policy, or any other insurance contract of this type in this state,
including a group insurance plan, a self-insurance plan, and the Office of Group Benefits
programs. "Health coverage plan" shall not include a plan providing coverage for excepted
benefits as defined in R.S. 22:1061, limited benefit health insurance plans, high deductible
health plans authorized under federal law, and short-term policies that have a term of less
than twelve months.