This text of Louisiana § 22:1059.6 (Required coverage for home visiting services; newborns and young children;) is published on Counsel Stack Legal Research, covering Louisiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
§1059.6. Required coverage for home visiting services; newborns and young children;
legislative findings; reimbursement methods; definitions
A. The legislature hereby finds and affirms all of the following:
(1)Home visiting services are evidence-based deliveries of services to families of
newborns, or families expecting newborns, provided by trained professionals in the home
that begin anywhere from before the twenty-eighth week of pregnancy and up to six weeks
after the birth of a child and continuing from up to two to five years after childbirth.
(2)Leading professional societies such as the American College of Obstetricians and
Gynecologists and the Society for Maternal-Fetal Medicine, and federal agencies such as the
Health Resources and Services Administration and the Centers for Me
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§1059.6. Required coverage for home visiting services; newborns and young children;
legislative findings; reimbursement methods; definitions
A. The legislature hereby finds and affirms all of the following:
(1) Home visiting services are evidence-based deliveries of services to families of
newborns, or families expecting newborns, provided by trained professionals in the home
that begin anywhere from before the twenty-eighth week of pregnancy and up to six weeks
after the birth of a child and continuing from up to two to five years after childbirth.
(2) Leading professional societies such as the American College of Obstetricians and
Gynecologists and the Society for Maternal-Fetal Medicine, and federal agencies such as the
Health Resources and Services Administration and the Centers for Medicare and Medicaid
Services, have recognized the well-established benefits of pre- and postpartum support
services provided by voluntary home visiting programs.
(3) Research demonstrates that support from home visiting programs is associated
with reduction of unnecessary emergency department visits and decreased use of public
assistance programs such as Temporary Assistance for Needy Families, the Supplemental
Nutrition Assistance Program, and Medicaid; fewer children in social welfare, mental health,
and juvenile corrections systems; and positive impacts on indicators related to cognitive
development and behavior, including higher intelligence quotients, language scores,
grade-point averages, achievement scores, and graduation rates.
(4) As Louisiana currently ranks as a state with one of the highest maternal and
infant mortality rates in the United States, this state has a compelling interest in and an
obligation to promote practices that improve maternal and infant health outcomes.
B.(1) A health coverage plan delivered or issued for delivery in this state that
provides benefits for maternity services shall include coverage for voluntary home visiting
services provided through a home visiting program that includes at least one visit during a
newborn's first three months of life, with the opportunity for the family to choose follow-up
visits, and at least one follow-up visit no later than three months after the last visit. A health
coverage plan may limit the total number of visits to a maximum of five visits from birth to
age three.
(2) The coverage required pursuant to this Section may be subject to annual
deductibles, coinsurance, and copayment provisions as are consistent with those established
under the health coverage plan. The coverage may also be subject to a limit per pregnancy
or childbirth of not less than one thousand five hundred dollars.
(3)(a) The requirements established by a health coverage plan to insure the support
services provided by a home visiting program before, during, and after childbirth shall not
preclude a home visiting program from operating in this state.
(b) A home visiting program may opt to practice in this state and forego any eligible
reimbursement via a health coverage plan; however, if the program aligns with an
evidence-based home visiting program model, it may provide services within the state to
whichever client or population desires its services.
(c) A health insurance issuer or health coverage plan may establish additional criteria
for approved home visiting services if the criteria allow at least one provider to be covered
by the plan.
(d) A health insurance issuer or health coverage plan, in its discretion, may determine
its method for reimbursement for expenses incurred for services provided pursuant to this
Section, including but not limited to utilization of any of the following:
(i) A value-based payment methodology.
(ii) An invoice claim process.
(iii) A capitated payment arrangement.
(iv) A payment methodology that considers the need for an agency or organization
providing services under the program to expand its capacity to provide services and address
health disparities.
(v) Any other payment arrangement agreed to by the insurer and an agency or
organization providing services under the program.
C. For the purposes of this Section, the following definitions apply:
(1) "Evidence-based home visiting program" means a home visiting program model
that meets the criteria of the United States Department of Health and Human Services for
evidence-based early childhood home visiting service delivery models as listed on the Home
Visiting Evidence of Effectiveness registry.
(2) "Health coverage plan" means the same as the term is defined in R.S. 22:1059.