LA SB363

Health insurers are prohibited from substituting a lower level of care for medically necessary treatment when the substitution contradicts the treating provider's determination and is based primarily on cost-containment or utilization management criteria

"Lower level of care" is defined as any healthcare service or setting providing less intensive treatment, monitoring, supervision, or therapeutic intervention than recommended by the treating provider

The prohibition does not apply when the substitute care is consistent with generally accepted standards of medical practice and is clinically appropriate for the patient's condition

Effective August 1, 2026