§ 22:2244 — Blanket insurance program; criteria by Louisiana Department of Health; exemptions

§2244. Blanket insurance program; criteria by Louisiana Department of Health; exemptions
A. Any blanket insurance program developed by the Louisiana Department of Health
shall include but not be limited to the following components:
(1) The eligibility criteria for individuals, including limiting participation to a
specific number of individuals who are eligible for medical assistance pursuant to a coverage
program implemented pursuant to approval of the secretary of the United States Department
of Health and Human Services using authority granted under Section 1115 of the Social
Security Act.
(2) The eligibility criteria for health insurance issuers that limit participation to
health insurance issuers who have not been found to be financially impaired by the
Department of Insurance in the preceding two years and have been selected by the Louisiana
Department of Health. For purposes of this Section, the term "health insurance issuer" shall
mean an insurance company, including a health maintenance organization as defined and
licensed pursuant to Subpart I of Part I of Chapter 2 of this Title, R.S. 22:241 et seq.
(3) The participation criteria that may limit the number of policies or contracts of
coverage that a participating health insurance issuer may issue under the program to twenty
percent of the health insurance issuer's other commercial coverage that satisfies the
requirements of R.S. 22:984, and 1061 through 1079.
(4) The health insurance criteria for health insurers that define the coverage that may
be provided under the program. The mandatory benefits or mandatory benefit options,
including the provision of "basic health care services" by health maintenance organizations,
shall not be required to be included in the program created by this Section.
(5) The payment methodology for participating health insurers.
(6) The provider payment requirements for participating health insurers.
B. In addition to the exemptions provided in Subsection A of this Section, R.S.
22:993, 1000(D) and (E), and 1836 shall not apply to any Louisiana Department of Health
blanket insurance program.

Legislative History

Acts 2004, No. 751, §1; Redesignated from R.S. 22:246.1 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2012, No. 271, §1.