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Donelon authorizes Emergency Rule 36 to address public health threat

From Staff Reports
Plaquemine Post South

Louisiana Insurance Commissioner Jim Donelon issued Emergency Rule 36 to address the statewide public health emergency by Governor Edwards declared to exist in the state of Louisiana as the result of the imminent threat posed to Louisiana citizens by COVID-19.

“This emergency rule, authorized by delegation of Governor Edwards’ emergency declaration, is a proactive effort by my staff to provide specific guidance to insurers as these conditions continue to impact the lives and health of citizens of our state,” said Donelon. “This effort will ensure Louisiana policyholders will have seamless access to testing, pharmaceuticals and care throughout Louisiana.”

Under Emergency Rule 36, insurers must:

  • Waive cost sharing for COVID-19 testing when ordered in accordance with CDC guidelines and are prohibited from requiring prior authorization for this testing.
  • Permit early refills, except for drugs in certain drug classes like opioids, when consistent with doctor/pharmacist approvals
  • Prohibit the use of step therapy
  • Enhance access to mail order pharmaceuticals
  • Continue to ensure network adequacy given the anticipated increase in demand due to COVID-19

The full text of Emergency Rule 36 can be found at https://www.ldi.la.gov/docs/default-source/documents/legaldocs/rules/rule36-cur-patientprotections. Additionally, other COVID-19 resources and FAQ’s are available on the LDI website or by following this link to www.ldi.la.com

About the Louisiana Department of Insurance: The Louisiana Department of Insurance works to improve competition in the state’s insurance market while assisting individuals and businesses with the information and resources they need to be informed consumers of insurance. As a regulator, the LDI enforces the laws that provide a fair and stable marketplace and makes certain that insurers comply with the laws in place to protect policyholders. You can contact the LDI by calling 1-800-259-5300 or visiting www.ldi.la.gov.