Louisiana Moves to Expand Medicaid Coverage for CAR T-Cell Therapy

In June 2023 Louisiana Governor John Bel Edwards signed into law a new bill aimed at broadening Medicaid coverage for chimeric antigen receptor T-cell (CAR T) therapy. The bill, which has been in effect since August 2023, was initially introduced by state Representative Aimee Adatto Freeman. Its passage represents a pivotal step in Louisiana’s commitment to enhancing health care options for individuals with cancer.

The bill was included in Part VII of Chapter 5-E of Title 40 of the Louisiana Revised Statutes. It delves into the specifics of extending Medicaid coverage for CAR T-cell therapy, an innovative treatment that harnesses the body's immune system to combat specific cancer cells.

The legislation outlines several key components:

• Defining CAR T-cell Therapy: The bill provides clear definitions for CAR T-cell therapy, stating that its purpose is to manipulate the body’s own T-cell proteins to target and eliminate cancerous cells.
• Mandating Medicaid Coverage: Louisiana's Medicaid program is now mandated to cover inpatient and, if necessary, outpatient CAR T-cell therapy, subject to approval by the U.S. Food and Drug Administration for medically accepted instances. This coverage extends to certified health care facilities following state and federal guidelines.
• Eligibility Criteria: To qualify for CAR T-cell therapy coverage under Louisiana Medicaid, individuals must be Medicaid members and have a licensed health care provider certify the medical necessity of the therapy for their cancer. The therapy must be administered in certified health care facilities.

By paving the way for expanded coverage of CAR T-cell therapy, lawmakers aim to provide hope and cutting-edge treatment options for patients with cancer across Louisiana and can serve as a model for other states in expanding access to innovative treatments.