Filed 10
Louisiana2026Enacted
HB870
Rules for Generic Drug and Biosimilar Coverage in Health Insurance
Last scannedAug 25, 2026, 3:26 AM
In one sentence
This law requires health insurance plans to cover qualifying generic drugs and biosimilars with lower out-of-pocket costs than brand-name versions if their wholesale acquisition cost is lower.
What it does
- Requires insurers to place qualifying generic drugs on a formulary tier that has better cost-sharing, including actual out-of-pocket costs, than the reference listed drug.
- Prohibits insurers from adding prior authorization or step therapy limits for these generics if those limits make them harder to get than brand-name drugs.
- Stops insurers from restricting which pharmacies can fill prescriptions for these cheaper alternatives compared to brand-name options.
- Allows insurers to use net cost calculations instead of wholesale acquisition costs when deciding formulary placement, provided they notify the state commissioner within thirty days with specific details.
- Mandates that the Department of Insurance publish an annual report summarizing notifications and analyzing the overall impact on patient drug costs.
Who it affects
- Health insurance issuers operating in Louisiana
- Patients enrolled in health plans who use prescription drugs covered under this law
Limits and unknowns
- These rules only apply if the generic or biosimilar has a lower wholesale acquisition cost than its reference product on the initial date of marketing and continues to be lower.
- The law requires insurers to notify the commissioner within thirty days if they choose to use net cost calculations instead of standard pricing methods.
Plain language
Terms to know
- Formulary
- A list of approved prescription drugs developed by experts that a health plan covers.
- Biosimilar
- A biological product licensed under federal law and listed in the FDA's Purple Book as similar to or interchangeable with an existing reference drug.
- Wholesale acquisition cost
- The price defined by federal statute used to compare drug costs before rebates are applied, unless a net cost calculation is chosen.
Official record
Sources
Official summary
INSURANCE/HEALTH: Provides relative to formulary placement and cost-sharing requirements for certain generic drugs and biosimilars (EN NO IMPACT See Note)
Official activity
Bill history
- Effective date: 08/01/2026.H
- Signed by the Governor. Becomes Act No. 907.H
- Sent to the Governor for executive approval.H
- Signed by the President of the Senate.S
- Enrolled and signed by the Speaker of the House.H
- Notice of Senate adoption of Conference Committee Report.H
- Conference Committee Report read; adopted by a vote of 36 yeas and 0 nays.S
- Notice House adopted the Conference Committee Report.S
- Conference Committee Report read, roll called, yeas 94, nays 0. The Conference Committee Report was adopted.H
- Scheduled for floor debate on 05/312026.H
- Conference committee report received.S
- Conference Committee report received. Lies over under the rules.H
- Notice House Conference Committee members appointed.S
- House conferees appointed: Turner, Firment, and Miller.H
- Notice of Senate conferees appointed.H
- Senate conference committee members appointed: Talbot, Bass, and Harris.S
- Notice House rejected the Senate amendments.S
- Read by title, roll called, yeas 99, nays 0, Senate amendments rejected, conference committee appointment pending.H
- Scheduled for concurrence on 05/26/2026.H
- Received from the Senate with amendments.H
Changes
Amendments
12 stored
Filed 11
This amendment clarifies how drug costs are calculated and requires insurance plans to offer lower-cost generic drugs and biosimilars with better prices while protecting patients currently taking brand-name medications from sudden changes.
This amendment fixes small formatting errors by removing the section symbol and the word 'Section' after references to U.S.C.
This amendment records a vote by the House to reject all changes proposed by the Senate for Bill HB870.
This amendment requires insurance plans to treat generic drugs and biosimilars at least as easily accessible as the brand-name versions they replace.
This amendment replaces the old definitions for key drug terms with new, specific legal descriptions based on federal laws and FDA databases.
This amendment replaces the original definitions section with new, specific legal descriptions for terms like biosimilars, brand drugs, generic drugs, and formularies.
This amendment changes how drug costs are calculated, requires insurance companies to share detailed cost data for certain discounts, and protects patients currently taking specific drugs from having their coverage changed without medical approval.
This amendment adds a new rule requiring health insurers to send written reports to state officials if they choose not to include cheaper generic or biosimilar drugs in their plans.
This amendment fixes spelling errors in the bill by changing 'cost sharing' to 'cost-sharing'.
This amendment adds a rule requiring health insurers to send written reports to state officials if they choose not to include cheaper generic or biosimilar drugs in their plans.