RS 22:1059.6

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RS 22:1059.6

§1059.6. Required coverage for home visiting services; newborns and young children; legislative findings; reimbursement methods; definitions

A. The legislature hereby finds and affirms all of the following:

(1)Home visiting services are evidence-based deliveries of services to families of newborns, or families expecting newborns, provided by trained professionals in the home that begin anywhere from before the twenty-eighth week of pregnancy and up to six weeks after the birth of a child and continuing from up to two to five years after childbirth.

(2)Leading professional societies such as the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, and federal agencies such as the Health Resources and Services Administration and the Centers for Medicare and Medicaid Services, have recognized the well-established benefits of pre- and postpartum support services provided by voluntary home visiting programs.

(3)Research demonstrates that support from home visiting programs is associated with reduction of unnecessary emergency department visits and decreased use of public assistance programs such as Temporary Assistance for Needy Families, the Supplemental Nutrition Assistance Program, and Medicaid; fewer children in social welfare, mental health, and juvenile corrections systems; and positive impacts on indicators related to cognitive development and behavior, including higher intelligence quotients, language scores, grade-point averages, achievement scores, and graduation rates.

(4)As Louisiana currently ranks as a state with one of the highest maternal and infant mortality rates in the United States, this state has a compelling interest in and an obligation to promote practices that improve maternal and infant health outcomes.

B.(1) A health coverage plan delivered or issued for delivery in this state that provides benefits for maternity services shall include coverage for voluntary home visiting services provided through a home visiting program that includes at least one visit during a newborn's first three months of life, with the opportunity for the family to choose follow-up visits, and at least one follow-up visit no later than three months after the last visit. A health coverage plan may limit the total number of visits to a maximum of five visits from birth to age three.

(2)The coverage required pursuant to this Section may be subject to annual deductibles, coinsurance, and copayment provisions as are consistent with those established under the health coverage plan. The coverage may also be subject to a limit per pregnancy or childbirth of not less than one thousand five hundred dollars.

(3)(a) The requirements established by a health coverage plan to insure the support services provided by a home visiting program before, during, and after childbirth shall not preclude a home visiting program from operating in this state.

(b)A home visiting program may opt to practice in this state and forego any eligible reimbursement via a health coverage plan; however, if the program aligns with an evidence-based home visiting program model, it may provide services within the state to whichever client or population desires its services.

(c)A health insurance issuer or health coverage plan may establish additional criteria for approved home visiting services if the criteria allow at least one provider to be covered by the plan.

(d)A health insurance issuer or health coverage plan, in its discretion, may determine its method for reimbursement for expenses incurred for services provided pursuant to this Section, including but not limited to utilization of any of the following:

(i)A value-based payment methodology.

(ii)An invoice claim process.

(iii)A capitated payment arrangement.

(iv)A payment methodology that considers the need for an agency or organization providing services under the program to expand its capacity to provide services and address health disparities.

(v)Any other payment arrangement agreed to by the insurer and an agency or organization providing services under the program.

C. For the purposes of this Section, the following definitions apply:

(1)"Evidence-based home visiting program" means a home visiting program model that meets the criteria of the United States Department of Health and Human Services for evidence-based early childhood home visiting service delivery models as listed on the Home Visiting Evidence of Effectiveness registry.

(2)"Health coverage plan" means the same as the term is defined in R.S. 22:1059.

Acts 2025, No. 190, §1.