reglab/housing_qa huggingface dataset:
LA Rev Stat § 22:1017 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§1017. Wellness or health improvement programs

RS 1017 - Wellness or health improvement programs A. A health insurance issuer may offer a voluntary wellness or health improvement program that allows for rewards or incentives including but not limited to merchandise, gift cards, debit cards, premium discounts or rebates, contributions toward a member's health savings account, modifications to copayment, deductible, or coinsurance amounts, or any combination of these incentives to encourage participation or to reward for participation in the program. B. Any reward or incentive established under this Section shall not violate Part IV of Chapter 7 of this Title if disclosed in the policy or certificate of authority of the health insurance issuer and filed with the Department of Insurance in accordance with existing state requirements. C. The insured or enrollee may be required to provide verification, such as a statement from his physician, that a medical condition makes it unreasonably difficult or medically inadvisable for the individual to participate in the wellness or health improvement program. D. Nothing in this Section shall prohibit health insurance issuers from offering incentives or rewards to members for adherence to wellness or health improvement programs if otherwise allowed by state or federal law. E. As used in this Section, "health insurance issuer" means any entity that offers health insurance coverage through a policy or certificate of insurance subject to state law that regulates the business of insurance. For purposes of this Section, a "health insurance issuer" shall include a health maintenance organization, as defined and licensed pursuant to Subpart I of Part I of Chapter 2 of this Title, nonfederal government plans subject to the provisions of Subpart B of Part II of Chapter 6 of this Title, and the Office of Group Benefits. Acts 2010, No. 280, §1, eff. June 17, 2010.
LA Rev Stat § 22:1018 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§1018. Choice in obtaining health insurance coverage

RS 1018 - Choice in obtaining health insurance coverage A. It is hereby declared that the public policy of this state, consistent with our constitutionally recognized and inalienable right of liberty, is that every person within this state is and shall be free from governmental intrusion in choosing or declining to choose any mode of securing health insurance coverage without penalty or threat of penalty. B. No resident of this state, regardless of whether he has or is eligible for health insurance coverage under any policy or program provided by or through his employer, or a plan sponsored by the state or the federal government, shall be required to obtain or maintain a policy of individual health insurance coverage. The state shall not impose a penalty or fee on any resident of the state for failure to obtain or maintain health insurance coverage. C. No provision in this Section shall be interpreted or held to supercede any provision of the Patient Protection and Affordable Care Act of 2010, P.L. 111-148 or any other federal law. Acts 2010, No. 952, §1.
LA Rev Stat § 22:1019.3 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§1019.3. Enforcement provisions; penalties; regulations

RS 1019.3 - Enforcement provisions; penalties; regulations A. If the commissioner determines that a health insurance issuer has not contracted with enough participating providers to ensure that covered persons have accessible health care services in a geographic area, that a health insurance issuer's access plan does not ensure reasonable access to covered health care services, or that a health insurance issuer has entered into a contract that does not comply with this Subpart, the commissioner may do either or both of the following: (1) Institute a corrective action plan that shall be followed by the health insurance issuer within thirty days of notice of noncompliance from the commissioner. (2) Use his other enforcement powers to obtain the health insurance issuer's compliance with this Subpart, including but not limited to disapproval or withdrawal of his approval. B. The commissioner shall not act to arbitrate, mediate, or settle disputes regarding a decision not to include a health care provider in a health benefit plan or in a provider network if the health insurance issuer has an adequate network as determined by the commissioner pursuant to the requirements contained in this Subpart. C. The commissioner may promulgate such rules and regulations as may be necessary or proper to carry out the provisions of this Subpart. Such rules and regulations shall be promulgated and adopted in accordance with the Administrative Procedure Act, R.S. 49:950 et seq. D.(1) The commissioner may issue, and cause to be served upon the health insurance issuer violating this Subpart, an order requiring such health insurance issuer to cease and desist from such act or omission for the whole state or any geographic area. (2) The commissioner may refuse to renew, suspend, or revoke the certificate of authority of any health insurance issuer violating any of the provisions of this Subpart, or in lieu of suspension or revocation of a license duly issued, the commissioner may levy a fine not to exceed one thousand dollars for each violation per health insurance issuer, up to one hundred thousand dollars aggregate for all violations in a calendar year per health insurance issuer, when such violations, in his opinion, after a proper hearing, warrant the refusal, suspension, or revocation of such certificate, or the imposition of a fine. The commissioner of insurance is authorized to withhold fines imposed under this Subpart. Such hearing shall be held in the manner provided in Chapter 12 of this Title, R.S. 22:2191 et seq. Additionally, the commissioner may take any other administrative action, including imposing those fines and penalties enumerated in R.S. 22:18. Acts 2013, No. 205, §1, eff. June 10, 2013.
LA Rev Stat § 22:1020.1 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§1020.1. Short title; purpose; scope; definitions

RS 1020.1 - Short title; purpose; scope; definitions  A. This Subpart shall be known and may be cited as the "Network Provider Directory Accessibility and Accuracy Act".  B. The purpose and intent of this Subpart is to establish standards for the creation and maintenance by a health insurance issuer of a directory of the issuer's network of healthcare providers and to ensure the accessibility and accuracy of the directory.  C. This Subpart shall apply to all health insurance issuers that offer health benefit plans in this state but shall not include excepted benefits policies as defined in R.S. 22:1061(3).  D. As used in this Subpart:  (1) "Commissioner" means the commissioner of insurance.  (2) "Covered person" means a policyholder, subscriber, enrollee, insured, or other individual participating in a health benefit plan.  (3) "Department" means the Department of Insurance.  (4) "Health benefit plan" means a policy, contract, certificate, or subscriber agreement entered into, offered, or issued by a health insurance issuer to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services.  (5) "Healthcare facility" means an institution providing healthcare services or a healthcare setting, including but not limited to hospitals and other licensed inpatient centers, ambulatory surgical or treatment centers, skilled nursing centers, diagnostic, laboratory, and imaging centers, and rehabilitation and other therapeutic health settings.  (6) "Healthcare professional" means a physician or other healthcare practitioner licensed, certified, or registered to perform specified healthcare services consistent with state law.  (7) "Healthcare provider" or "provider" means a healthcare professional or a healthcare facility.  (8) "Healthcare services" means services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease.  (9) "Health insurance issuer" means an entity subject to the insurance laws and regulations of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract, or enters into an agreement to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services, including a sickness and accident insurance company, a health maintenance organization, a preferred provider organization or any similar entity, or any other entity providing a plan of health insurance or health benefits.  (10) "Network of providers" or "network" means an entity, including a health insurance issuer, that, through contracts or agreements with healthcare providers, provides or arranges for access by groups of covered persons to healthcare services by healthcare providers who are not otherwise or individually contracted directly with a health insurance issuer.  Acts 2018, No. 290, §1, eff. Jan. 1, 2019.
LA Rev Stat § 22:1020.2 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§1020.2. Provider directory; content; accessibility

RS 1020.2 - Provider directory; content; accessibility  A. A health insurance issuer shall maintain a directory of the issuer's network of providers on the internet.  B. The directory shall include the name, specialty, if any, street address, and telephone number of each healthcare provider and indicate whether the provider is accepting new patients.  C. The directory shall be all of the following:  (1) Electronically searchable by healthcare provider name, specialty, if any, and location.  (2) Publicly accessible without necessity of providing a password, a user name, or personally identifiable information.  Acts 2018, No. 290, §1, eff. Jan. 1, 2019.
LA Rev Stat § 22:1020.3 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§1020.3. Continuous review required

RS 1020.3 - Continuous review required  A. A health insurance issuer shall conduct an ongoing review of the issuer's provider directory and correct or update the information as necessary. Except as provided in Subsections B and C of this Section, corrections and updates, if any, shall be made not less than once every twenty business days.  B. The health insurance issuer shall update the directory to list a healthcare provider not later than ten business days after the effective date of the provider's credentialing with the health insurance issuer.  C. The health insurance issuer shall update the directory to remove a healthcare provider not later than ten business days after the effective date of the termination of the provider's credentialing with the health insurance issuer.  Acts 2018, No. 290, §1, eff. Jan. 1, 2019.
LA Rev Stat § 22:1020.4 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§1020.4. Reporting of inaccurate information

RS 1020.4 - Reporting of inaccurate information  A. A health insurance issuer shall conspicuously display in the issuer's provider directory an email address, a toll-free telephone number, or another mechanism that is easily accessible to any individual by which the individual may report any inaccuracy in the directory.  B. If the health insurance issuer receives a report from any person that specifically identified directory information may be inaccurate, the issuer shall investigate the report and correct the information, as necessary, in accordance with the following schedule:  (1) Not later than the second business day after the date the report is received if the report concerns the health insurance issuer's representation of the network participation status of a healthcare provider.  (2) Not later than the fifth business day after the date the report is received if the report concerns any other type of information in the directory.  Acts 2018, No. 290, §1, eff. Jan. 1, 2019.
LA Rev Stat § 22:1020.5 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§1020.5. Investigation by the commissioner; assessment; penalties; applicability

RS 1020.5 - Investigation by the commissioner; assessment; penalties; applicability  A. If, in any thirty-day period, a health insurance issuer receives three or more reports that allege the issuer's directory inaccurately represents a healthcare provider's network participation status and that are confirmed by the issuer's investigation, the health insurance issuer shall immediately report that occurrence to the commissioner.  B. On receipt of a report pursuant to Subsection A of this Section, the commissioner shall investigate the health insurance issuer's compliance with the provisions of this Subpart.  C. The department may collect an assessment in an amount determined by the commissioner from the health insurance issuer at the time of the investigation to cover all expenses attributable directly to the investigation, including but not limited to the salaries and expenses of department employees and all reasonable expenses of the department necessary for the administration of this Subpart.  D. Except as otherwise provided in Subsection F of this Section, the Department of Insurance may promulgate rules and regulations to provide for civil fines payable by a health insurance issuer not to exceed five hundred dollars for each act of violation of the requirements of this Subpart, not to exceed an aggregate fine of fifty thousand dollars. For purposes of this Subsection, "act of violation" is limited to an intentional act or an act of gross negligence.  E.(1) A health insurance issuer shall not be responsible for information that is inaccurately submitted or not submitted by healthcare providers as stated in their contract.  (2) The penalties provided for in this Section shall be the exclusive remedy for any violations and there shall be no independent cause of action by any person based upon a violation or other information reported.  F. The provisions of this Subpart shall apply to the Office of Group Benefits; however, the commissioner of insurance shall not levy an assessment or fine against the Office of Group Benefits. If the commissioner of insurance concludes that the Office of Group Benefits has violated this Subpart, the commissioner of insurance shall notify the commissioner of administration in writing within thirty days of the violation.  Acts 2018, No. 290, §1, eff. Jan. 1, 2019.
LA Rev Stat § 22:1020.6 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§1020.6. Printed form available upon request

RS 1020.6 - Printed form available upon request  The directory of network providers required pursuant to this Subpart shall be furnished in printed form to any covered person upon request.  Acts 2018, No. 290, §1, eff. Jan. 1, 2019.
LA Rev Stat § 22:1020.51 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§1020.51. Purpose and intent

RS 1020.51 - Purpose and intent  The purpose and intent of this Subpart is to ensure patient access to physician-administered drugs and related services furnished to persons covered under a health insurance contract. This Subpart shall ensure that health insurance issuers do not interfere with patients' freedom of choice with respect to providers furnishing physician-administered drugs and ensure that patients receive safe and effective drug therapies.  Acts 2021, No. 50, §1, eff. June 1, 2021.
LA Rev Stat § 22:1020.52 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§1020.52. Definitions

RS 1020.52 - Definitions  For purposes of this Subpart, the following words shall have the following meanings:  (1) "Covered person" shall have the same meaning as provided in R.S. 22:1019.1.  (2) "Health insurance issuer" shall have the same meaning as provided in R.S. 22:1019.1.  (3) "Participating provider" shall have the same meaning as provided in R.S. 22:1019.1. For purposes of this Subpart, "participating provider" shall include any clinic, hospital outpatient department, or pharmacy under the common ownership or control of the participating provider.  (4) "Physician-administered drug" means any prescription drug, as defined in R.S. 22:1060.1, other than a vaccine, that requires administration by a provider and is not approved as a self-administered drug.  Acts 2021, No. 50, §1, eff. June 1, 2021.
LA Rev Stat § 22:1020.53 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§1020.53. Physician-administered drugs; access; payment

RS 1020.53 - Physician-administered drugs; access; payment  A.(1) A health insurance issuer, pharmacy benefit manager, or their agent shall not refuse to authorize, approve, or pay a participating provider for providing covered physician-administered drugs and related services to covered persons. A health insurance issuer shall not condition, deny, restrict, refuse to authorize or approve, or reduce payment to a participating provider for a physician-administered drug when all criteria for medical necessity are met, because the participating provider obtains physician-administered drugs from a pharmacy that is not a participating provider in the health insurance issuer's network. The drug supplied shall meet the supply chain security controls and chain of distribution set by the federal Drug Supply Chain Security Act, Pub. L. 113-54, as amended. The payment shall be at the rate set forth in the health insurance issuer's agreement with the participating provider applicable to such drugs, or if no such rate is included in the agreement, then at the wholesale acquisition cost. A health insurance issuer, pharmacy benefit manager, or their agent, shall not require a covered person to pay an additional fee, or any other increased cost-sharing amount in addition to applicable cost-sharing amounts payable by the covered person as designated within the benefit plan to obtain the physician-administered drug when provided by a participating provider. However, nothing in this Subpart shall prohibit a health insurance issuer or its agent from establishing differing copayments or other cost-sharing amounts within the benefit plan for covered persons who acquire physician-administered drugs from other providers. Nothing in this Subpart shall prohibit a health insurance issuer or its agent from refusing to authorize or approve, or from denying coverage of a physician-administered drug based upon failure to satisfy medical necessity criteria. For purposes of this Section, the location of receiving the physician-administered drug shall not be included in the medical necessity criteria.  (2) Nothing in this Section shall prohibit a health insurance issuer from establishing specialty care centers of excellence based on nationally established, objective quality measures, to be utilized by covered persons focused on specific drugs or types of drugs to impact the safety, quality, affordability, and expertise of treatment.  B. The commission of any act prohibited by this Subpart shall be considered an unfair method of competition and unfair practice or act which shall subject the violator to any and all actions, including investigative demands, private actions, remedies, and penalties, provided for in the Unfair Trade Practices and Consumer Protection Law.  C. Any provision of a contract that is contrary to any provision of this Subpart shall be null, void, and unenforceable in this state.  Acts 2021, No. 50, §1, eff. June 1, 2021.
LA Rev Stat § 22:1021 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§1021. Prohibition of discrimination against dental care services

RS 1021 - Prohibition of discrimination against dental care services  A. Whenever the terms "physician", "surgeon", "medical doctor", or any other terms which refer to licensed practitioners of the healing arts are used in any health and accident insurance policy, group health and accident insurance policy, certificate of insurance, contract providing coverage for hospital service, medical or surgical benefits as set out in R.S. 22:839, miscellaneous insurance contract authorized by R.S. 22:47(14) which provides benefits for hospital and medical care, public employee group benefit program document, subscriber contract providing health care treatment coverage, or any other policy, contract, or document providing for the payment of health care treatment procedures which are specified in the policy, contract, or document and are within the scope of a dentist's professional license, such terms shall be construed to include a dentist, licensed under the laws of the state of Louisiana governing the practice of dentistry under Chapter 9, Title 37, Louisiana Revised Statutes of 1950, who performs such specified treatment procedures. B. Payment shall not be denied for a service provided by a person licensed to engage in the practice of dentistry if that service would be a covered service if provided by a person licensed to engage in the practice of medicine and surgery, if the service can be lawfully performed within the scope of a person's license to practice dentistry. C. The provisions of this Section shall be applicable only with respect to policies, contracts, or other documents delivered, issued for delivery, promulgated, or renewed in this state on or after January 1, 1990. D. This Section shall not be construed to mandate that any benefit or health care treatment be authorized and included in a policy, contract, or other document. Added by Acts 1974, No. 544, §1; Acts 1989, No. 817, §1; Redesignated from R.S. 22:213.1 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009. NOTE: Former R.S. 22:1321 redesignated as R.S. 22:801 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:1022 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§1022. Prohibited discrimination; prenatal test results

RS 1022 - Prohibited discrimination; prenatal test results A. No hospital, health, or medical expense insurance policy, hospital or medical service contract, employee welfare benefit plan, health and accident insurance policy, or any other insurance contract of this type, including a group insurance plan, or any policy of group, family group, blanket, or association health and accident insurance, a self-insurance plan, health maintenance organization, and preferred provider organization, which delivers or issues for delivery in this state an insurance policy or plan shall, on the basis of any prenatal test result: (1) Terminate, restrict, limit, or otherwise apply conditions to the coverage under the policy or plan, or restrict the sale of the policy or plan in force. (2) Cancel or refuse to renew the coverage under the policy or plan in force. (3) Deny coverage or exclude an individual or family member from coverage under the policy or plan in force. (4) Impose a rider that excludes coverage for certain benefits or services under the policy or plan in force. (5) Establish differentials in premium rates or cost sharing for coverage under the policy or plan in force. (6) Otherwise discriminate against an individual or family member in the provision of insurance. B. The provisions of this Section shall not apply to tests conducted to determine pregnancy. Acts 1997, No. 1418, §1; Acts 2003, No. 129, §1, eff. May 28, 2003; Redesignated from R.S. 22:213.6 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009. NOTE: Former R.S. 22:1022 redesignated as R.S. 22:802 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.