Provides relative to expand glucose-improving medications coverage to individuals based on body mass index

House Bill 869 creates a new section of Louisiana Revised Statutes Title 22, specifically R.S. 22:1028.7, which establishes mandatory coverage requirements for injectable drugs used to improve glucose levels or facilitate weight loss under health insurance plans. The statute requires that health coverage plans renewed, delivered, or issued for delivery in Louisiana must provide coverage for FDA-approved injectable drugs prescribed by a licensed healthcare provider for treating prediabetes, gestational diabetes, or obesity when a covered person has been diagnosed with one of these conditions and the drug is medically necessary for treatment. The law applies to injectable drugs that appear on the insurer's formulary or preferred drug list and permits insurers to apply customary cost-sharing mechanisms including annual deductibles, coinsurance, and copayments consistent with the plan's established provisions, as well as prior authorization requirements.

The legislation directly affects health insurance coverage for Louisiana residents with prediabetes, gestational diabetes, or obesity who would otherwise face denials of coverage for these medications. Health insurers operating in Louisiana, including group health plans, self-insured plans, the Office of Group Benefits programs, health maintenance organizations, and preferred provider organizations, must modify their formularies and coverage policies to include these injectable drugs. Individual policyholders and employers sponsoring health plans will experience expanded access to these medications with standard cost-sharing obligations, while health plans may require covered persons to participate in lifestyle management programs if such programs are available through the health coverage plan.

This legislation operates within Louisiana's existing insurance regulatory framework under Title 22 of the Louisiana Revised Statutes, which governs insurance generally and includes numerous other mandated coverage requirements for specific treatments and services. The statute expressly excludes limited benefit health insurance plans, excepted benefits as defined in R.S. 22:1061, and short-term policies with terms less than twelve months from its requirements, thereby narrowing its scope to comprehensive health coverage arrangements. The effective date provisions establish that new policies issued on or after January 1, 2026, must comply immediately, while existing policies in effect before that date must conform to the new requirements by their renewal date but no later than January 1, 2027, allowing insurers a transition period for plan modifications and administrative compliance.