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HLS 26RS-43 ORIGINAL
2026 Regular Session
HOUSE BILL NO. 869
BY REPRESENTATIVE LYONS
INSURANCE/HEALTH: Provides relative to expand glucose-improving medications
coverage to individuals based on body mass index
1 AN ACT
2 To enact R.S. 22:1028.7, relative to health insurance; to provide coverage for injectable
3 drugs for the improvement of glucose levels or weight loss; to provide coverage
4 requirements; to provide definitions; to provide for applicability; to provide an
5 effective date; and to provide for related matters.
6 Be it enacted by the Legislature of Louisiana:
7 Section 1. R.S. 22:1028.7 is hereby enacted to read as follows:
8 §1028.7. Required coverage for injectable drugs to improve glucose levels or for
9 weight loss
10 A. As used in this Section, the following terms have the following meanings:
11 (1) "Body mass index" means a practical marker used to assess the degree
12 of obesity, calculated by dividing the weight in kilograms by the height in meters
13 squared.
14 (2) "Health coverage plan" means any hospital, health, or medical expense
15 insurance policy, hospital or medical service contract, employee welfare benefit plan,
16 contract, or other agreement with a health maintenance organization or a preferred
17 provider organization, health and accident insurance policy, or any other insurance
18 contract of this type in this state, including a group insurance plan, self-insurance
19 plan, and the Office of Group Benefits programs. "Health coverage plan" does not
20 include a plan providing coverage for excepted benefits defined in R.S. 22:1061,
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
HLS 26RS-43 ORIGINAL
HB NO. 869
1 limited benefit health insurance plans, and short-term policies that have a term of
2 less than twelve months.
3 (3) "Injectable drug" means a drug approved by the United States Food and
4 Drug Administration for use to lower glucose levels or for weight loss.
5 (4) "Obesity" means a body mass index equal to or greater than thirty
6 kilograms per meter squared.
7 B.(1) A health coverage plan renewed, delivered, or issued for delivery in
8 this state shall not deny coverage for an injectable drug to lower glucose levels or for
9 weight loss if all of the following apply:
10 (a) The injectable drug has been approved by the United States Food and
11 Drug Administration for use to lower glucose levels or for weight loss.
12 (b) The drug is prescribed by a licensed healthcare provider for the treatment
13 of prediabetes, gestational diabetes, or obesity when a covered person is diagnosed
14 or has been previously diagnosed with prediabetes, gestational diabetes, or obesity,
15 and the drug is medically necessary for the treatment of this disease or condition.
16 (c) The drug is on the insurer's formulary or preferred drug list, if any.
17 (2) The coverage provided in this Section may be subject to annual
18 deductibles, coinsurance, and copayment provisions as are consistent with those
19 established under the health coverage plan and may be subject to prior authorization.
20 (3) A health coverage plan may include a provision that an injectable drug
21 used for the treatment of prediabetes, gestational diabetes, or obesity continue to be
22 medically necessary as certified by the treating healthcare provider.
23 (4) A health coverage plan may include a provision that a covered person
24 shall participate in a lifestyle management plan administered by the health coverage
25 plan, if available.
26 Section 2. This Act shall apply to any new policy, contract, program, or health
27 coverage plan issued on and after January 1, 2026. Any policy, contract, or health coverage
28 plan in effect prior to January 1, 2026, shall convert to conform to this Act on or before the
29 renewal date, but no later than January 1, 2027.
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
HLS 26RS-43 ORIGINAL
HB NO. 869
1 Section 3. This Act shall become effective upon signature by the governor or, if not
2 signed by the governor, as provided by Article III, Section 18 of the Constitution of
3 Louisiana. If vetoed by the governor and subsequently approved by this legislature, this Act
4 shall become effective on the day following such approval.
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 869 Original 2026 Regular Session Lyons
Abstract: Requires health coverage for medication that improve glucose levels.
Proposed law provides definitions for "body mass index", "health coverage plan", "injectable
drug", and "obesity".
Proposed law requires a health coverage plan renewed, delivered, or issued for delivery in
this state to provide coverage for an injectable drug to lower glucose levels or for weight
loss, if all of the following apply:
(1) The drug has been approved by the United States Food and Drug Administration
(FDA) for lowering glucose levels or for weight loss.
(2) The drug that is approved by the FDA is prescribed by a licensed healthcare provider
for the treatment of prediabetes, gestational diabetes, or obesity, and the covered
person is diagnosed or previously diagnosed with prediabetes, gestational diabetes,
or obesity, and the drug is medically necessary for the treatment of prediabetes,
gestational diabetes, or obesity.
(3) The drug is on the insurer's formulary or preferred drug list, if any.
Proposed law provides that a health coverage plan may apply annual deductibles,
coinsurance, and copayment provisions as are consistent with those established under the
health coverage plan and coverage may be subject to prior authorization.
Proposed law authorizes a health coverage plan to include a provision that the treatment for
prediabetes, gestational diabetes, or obesity continue to be medically necessary as certified
by a healthcare provider.
Proposed law authorizes a health coverage plan to require a covered person using an
injectable drug to lower glucose or for weight loss to participate in a lifestyle management
plan administered by the health coverage plan, if available.
Proposed law is effective for any new policy, contract, program, or health coverage plan in
effect prior to Jan. 1, 2026, and for any policy, contract, or health coverage plan in effect
prior to Jan. 1, 2026, the policy, contract, or health coverage in effect is required to conform
to the provisions of proposed law on or before the renewal date, but no later than Jan. 1,
2027.
Effective upon the signature of governor or lapse of time for gubernatorial action.
(Adds R.S. 22:1028.7)
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.