Provides relative to Medicaid prior authorization during a declared emergency. (8/1/25) (EN NO IMPACT See Note)
Summary
SB 182 authorizes the Louisiana Department of Health to suspend Medicaid utilization management requirements, including prior authorization and concurrent review, during a governor-declared state of emergency. The goal is to keep medically necessary care flowing for Medicaid recipients when emergencies disrupt normal access to doctors, pharmacies, equipment, and other services.
The bill requires Medicaid managed care organizations, pharmacy benefit managers, and fee-for-service claims processors to pay providers for medically necessary drugs, services, equipment, supplies, and therapies furnished during the emergency without prior authorization. It also specifically covers out-of-state providers who treat Louisiana Medicaid recipients who evacuate during an emergency, whether the evacuation is voluntary or involuntary. The suspension applies only to Medicaid recipients living in the designated emergency area, and managed care organizations must notify recipients about the suspension and their rights through providers, outreach, and online platforms.
Impact
SB 182 adds R.S. 46:460.76.3 to Louisiana law and creates a new emergency-specific Medicaid rule allowing the Department of Health to waive prior authorization and related utilization controls during declared emergencies. It affects Medicaid managed care organizations, pharmacy benefit managers, fee-for-service claims administrators, providers, and Medicaid recipients in emergency zones, and it requires reimbursement for covered care delivered during the emergency, including care from out-of-state providers treating evacuees.
Sentiment
The bill appears to have been broadly supported and noncontroversial. It passed the Senate 39-0 and the House 95-0, with additional Senate co-author support, suggesting strong bipartisan agreement that emergency conditions justify temporary relaxation of prior authorization rules to protect continuity of care for Medicaid patients.
Contention
No major opposition is reflected in the available record, and there were no committee transcripts provided showing debate. The only potentially sensitive policy issue is the balance between emergency access to care and the administrative/utilization controls normally used by Medicaid managed care organizations and pharmacy benefit managers, but the unanimous votes indicate little or no public contention over that tradeoff.