Louisiana patients receive balance billing protections from both state law and the federal No Surprises Act. Understanding these overlapping protections helps you dispute unexpected out-of-network bills effectively.
Louisiana Senate Bill 13 (2021)
Louisiana SB 13, enacted in 2021, provides balance billing protections for Louisiana patients, particularly for emergency services. This state law was among the first to address surprise billing and aligns with the principles of the federal No Surprises Act.
Federal No Surprises Act as Primary Protection
The federal No Surprises Act, effective January 1, 2022, is the primary balance billing protection for Louisiana patients. It provides broader coverage than Louisiana SB 13 alone and preempts weaker state rules. Patients are responsible for in-network cost-sharing only for NSA-covered services.
What Services Qualify for Protection
Both Louisiana SB 13 and the federal NSA protect patients receiving emergency services at any facility and scheduled non-emergency services at in-network facilities provided by out-of-network providers. Patients pay in-network cost-sharing amounts only.
Insurance Plan Jurisdiction
The Louisiana Department of Insurance (LDI) handles complaints for state-regulated health plans, while the Centers for Medicare and Medicaid Services (CMS) oversees ERISA self-insured plans. Identifying your plan type determines where to file a complaint.
How to Dispute Balance Bill in Louisiana
- Verify the service type and network status align with NSA or SB 13 coverage requirements.
- Contact the health plan in writing citing federal NSA and Louisiana SB 13.
- Request an in-network rate adjustment with supporting bill documentation.
- File an LDI complaint for state plans or a CMS complaint for ERISA plans if unresolved within 30 days.
Altair identifies balance billing violations across Louisiana plans and ensures you recover full payment.
See how Altair enforces Louisiana balance billing protections
Frequently Asked Questions
Does Louisiana have its own balance billing law?
Yes, Louisiana SB 13 (2021) provides balance billing protections. However, the federal No Surprises Act is the primary protection and often provides greater coverage than Louisiana's state law alone.
How does Louisiana's SB 13 relate to the federal NSA?
Louisiana SB 13 was enacted before the federal No Surprises Act and addresses similar concerns. The federal NSA preempts weaker state rules, so it typically provides the greater protection for Louisiana patients.
Can Louisiana patients waive balance billing protections?
No, neither Louisiana SB 13 nor the federal No Surprises Act allow patients to waive these protections. Any agreement waiving coverage is void and unenforceable.
Related Louisiana Insurance Topics
- Louisiana Timely Filing Requirements
- Louisiana Surprise Billing Protections
- Louisiana Prior Authorization Rules
- All State Billing Laws
- Federal No Surprises Act