Louisiana § RS 40:2212 - Basic benefit plans
Full text of Louisiana Louisiana Civil Code § RS 40:2212 — Basic benefit plans, with citation guidance and answers to common questions.
§ RS 40:2212. Basic benefit plans
A. A qualified plan shall provide full disclosure of services to each enrollee or prospective enrollee, including covered benefits, restrictions and/or limitations, specialty care, prescription drugs and biologics, the inclusion of essential community providers, the use of providers outside of a plan's provider network, and experimental treatments.
B. Each qualified plan shall disclose to each enrollee or prospective enrollee orally or in writing in a manner understandable at a fifth grade reading level and reviewed and approved by the literacy program of the Louisiana State University Health Sciences Center in Shreveport:
(1) A definition of basic covered benefits.
(2) Guidelines for confidential communication with caregivers.
(3) Availability and access to choice of providers.
(4) Quality assurance requirements.
(5) Disclosure of protocols as it relates to courteous treatment, timely referrals, and access to specialty care.
(6) Disclosure of deductibles.
(7) Extent of inclusion or exclusion of preventive health services in all basic benefit programs.
(8) Disclosure of definition of "necessary treatment".
(9) Information regarding appeal process.
C.(1) Any qualified plan shall not exclude from direct reimbursement health care services provided by an advanced practice registered nurse who provides health care services in accordance with the collaborative practice agreement for basic benefit services covered by the basic health plan.
(2) Any qualified plan shall not reimburse health care services provided by an advanced practice registered nurse at a rate less than the rate paid to other health care providers who perform the same services.
Acts 1995, No. 621, §1, eff. June 18, 1995; Acts 1999, No. 802, §5, eff. July 2, 1999; Acts 2001, No. 704, §1; Acts 2006, No. 106, §1.
Frequently Asked Questions About Louisiana § RS 40:2212
What does Louisiana Civil Code § RS 40:2212 cover?
Section RS 40:2212 ("Basic benefit plans") is part of the Louisiana Civil Code, the codified statutory law of Louisiana. It sets out the legal rule or procedure described in the text above. Statutes are amended regularly, so always verify against the official source.
How do I cite Louisiana § RS 40:2212?
A common citation format is "Louisiana Civil Code § RS 40:2212" (Louisiana). Legal writing may require the code abbreviation, section number, and year or edition. Match the style required by your court, professor, or publisher.
Is this the official text of Louisiana law?
No. This page is for research and education and may not include the most recent amendments. For official current law, check the Louisiana official source linked on this page or consult a licensed Louisiana attorney.
How does Louisiana § RS 40:2212 apply to my situation?
Statutes are interpreted in context, and application depends on your specific facts. Only a licensed attorney in Louisiana can advise on how this section applies to you. Contact your state or local bar association for a referral.
Sources & Verification
Not legal advice. Verify against the official source and consult a licensed attorney in Louisiana.