SR 170

2026 Regular Session  ENROLLED
SENATE RESOLUTION NO. 170
BY SENATOR TALBOT
  A RESOLUTION
To urge and request the Department of Insurance and the Louisiana Department of Health
       to conduct a joint comprehensive review and study of the implementation and
       enforcement of Louisiana's biomarker testing coverage law and to report their
       findings.
       WHEREAS, Louisiana enacted legislation requiring health insurance coverage for
biomarker testing when supported by medical and scientific evidence and recognized clinical
practice guidelines; and
       WHEREAS, biomarker testing plays a critical role in the diagnosis, treatment, and
management of cancer and other serious diseases by enabling personalized and
precision-based medical care; and
       WHEREAS, delays between the initial physician request for biomarker testing and
the eventual administration of testing may negatively impact patient outcomes, delay
treatment decisions, and increase the risk of disease progression; and
       WHEREAS, timely access to evidence-based biomarker testing is increasingly
recognized as a standard component of precision medicine and modern cancer care; and
       WHEREAS, stakeholders, including patients, healthcare providers, laboratories, and
insurers, have raised concerns regarding access to biomarker testing, claims adjudication and
utilization management practices, use of Proprietary Laboratory Analyses (PLA) codes,
denial patterns, appeals processes, and delays in testing approval and administration; and
       WHEREAS, the legislature has an interest in ensuring that the biomarker testing
coverage law is being implemented consistently, fairly, and in accordance with legislative
intent; and
       WHEREAS, a comprehensive review of claims data and implementation practices
would assist the legislature in evaluating whether additional statutory or regulatory action
is necessary to ensure patient access to medically appropriate biomarker testing.
       THEREFORE, BE IT RESOLVED that the Senate of the Legislature of Louisiana
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SR NO. 170  ENROLLED
does hereby urge and request the Department of Insurance and the Louisiana Department of
Health to conduct a joint comprehensive review and study of the implementation and
enforcement of Louisiana's biomarker testing coverage law from January 1, 2024, through
the present.
  BE IT FURTHER RESOLVED that a written report of findings and
recommendations shall be submitted to the Senate and House committees on insurance and
the Senate and House committees on health and welfare no later than February 1, 2027.
  BE IT FURTHER RESOLVED that the report shall include but not be limited to the
following:
  (1) The number of biomarker testing claims submitted to health insurers and
managed care organizations operating in Louisiana.
  (2) The number of claims approved, denied, partially denied, or otherwise not paid
in full.
  (3) The reasons for denial or adverse benefit determinations, including prior
authorization requirements, medical necessity determinations, coding issues, network
limitations, or other administrative grounds.
  (4) The average length of time between the initial request for biomarker testing by
a healthcare provider and the administration or completion of the test.
  (5) The number and outcomes of appeals, reconsiderations, grievances, or external
reviews related to biomarker testing claims.
  (6) A review of all adjudication and utilization management practices associated with
biomarker testing claims, including timelines for review and payment.
  (7) The utilization and reimbursement of Proprietary Laboratory Analyses (PLA)
codes and any other billing codes commonly associated with biomarker testing.
  (8) Aggregate approval, denial, and appeal data categorized by insurer, managed care
organization, and biomarker testing category to the extent permitted by law.
  (9) Identification of any barriers to patient access to biomarker testing services,
including administrative, reimbursement, network-related, or timing-related barriers.
  (10) Recommendations for legislative, regulatory, or administrative changes
necessary to improve compliance, transparency, and patient access.
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SR NO. 170  ENROLLED
       BE IT FURTHER RESOLVED that the Department of Insurance and the Louisiana
Department of Health, in conducting the study, may consult with stakeholders and interested
parties, including healthcare providers, patient advocacy organizations, laboratories,
insurers, and managed care organizations.
       BE IT FURTHER RESOLVED that one print copy and one electronic copy of the
report produced pursuant to this Resolution shall be submitted to the David R. Poynter
Legislative Research Library as required by R.S. 24:772.
       BE IT FURTHER RESOLVED that a copy of this Resolution be transmitted to the
commissioner of insurance and the secretary of the Louisiana Department of Health.
  PRESIDENT OF THE SENATE
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