House Bill No. [insert number] proposes amendments to the Louisiana Workers' Compensation Law, specifically R.S. 23:1034.2, to establish a medical fee reimbursement schedule for workers' compensation claims. The bill mandates that the assistant secretary of the office of workers' compensation administration will create and implement this reimbursement schedule, which will now be based on the amount due under Medicare multiplied by one and one-half, or the actual charge for the service, whichever is lower. The bill also introduces a new provision that if there is no Medicare fee schedule for a specific service, the reimbursement amount will be set at 162% of the reasonable cost, with the burden of proof on the party seeking reimbursement to demonstrate that the amount is reasonable.

Additionally, the bill repeals the assistant secretary's authority to collect certain information for calculating the reimbursement schedule and the confidentiality requirements surrounding this data. Instead, it allows the assistant secretary to adopt rules and regulations for establishing reimbursement amounts in the absence of a Medicare fee schedule. Furthermore, in disputes between healthcare providers and payors regarding the reimbursement amounts, the bill stipulates that the prevailing party will be awarded reasonable attorney fees based on the actual fees incurred.

Statutes affected:
HB870 Original: 23:2(A)