Louisiana

- In 2014 Louisiana became the sixth state to pass DPC legislation with Senate Bill No. 516.  The law has now been made a part of the Louisiana Revised Statutes sections 37:1360.81 through 1360.91.  The links to each section of the law are as follows:

- Louisiana's "Direct Primary Care Practice" laws were the best legislative example at the time of their passage.  These laws appropriately protected DPC physicians from "business of insurance" accusations and provided a reasonable definition of DPC.  The legislation stopped short of using language to clarify DPC from concierge practices.    At the time, Louisiana was the first state to pass DPC legislation without any legislative resistance or DPC practice "business of insurance" allegations from the office of the state insurance commissioner.  A white paper about DPC prepared by Flood International Consulting Agency was likely helpful for the legislators.  In spite of this legislation one should still review the Louisiana Insurance Code when setting up a practice.  

- Multiple DPC practices are now operating within the state of Louisiana and the Louisiana Academy of Family Physicians openly promotes and supports direct primary care.  A Louisiana Direct Primary Care Coalition has formed as well and they are a great resource for physicians considering DPC in Louisiana.  

- In office dispensing in Louisiana can be a bit onerous.  The Louisiana State Board of Medical Examiners lists their requirements for obtaining a permit on their website (scroll half way down the page under "other forms / applications" to find the dispensing physician permits).  Here are the highlights:

1) You must pay a $75.00 application fee, and a $50 (presumably yearly) fee for each renewal period
2) Controlled substances are difficult to dispense (probably a good thing) - limited to 48 hour supply, this option is only available to physicians that have been in practice for greater than three years
3) The initial application asks that you "list all medications proposed to be dispensed. Include brand or generic name, CDS schedule, dosage, quantity."

For full details you will also want to read Chapter 65 of Title 46 Professional and Occupational Standards (starting on page 37 of this link).  Note the detailed requirements in Subchapter D (Record keeping of purchases, acquisitions, medication inventories, dispensation records, other transaction records, computerized records, and retention of records), Subchapter E (labeling and packaging) and Subchapter F (Security).