House Bill No. by Representative Echols aims to amend the existing workers' compensation laws in Louisiana by establishing a new medical fee reimbursement schedule. The bill mandates that the assistant secretary of the office of workers' compensation administration will create a reimbursement schedule for various medical services, drugs, and supplies. The proposed changes include a shift from using the mean of usual and customary charges to a calculation based on the Medicare reimbursement amount multiplied by one and one-half, or the actual charge for the service, whichever is lower. Additionally, if there is no Medicare fee schedule for a specific service, the reimbursement will be set at 162% of the reasonable amount, with the burden of proof on the party seeking reimbursement.

The bill also repeals the assistant secretary's authority to collect certain information for calculating the reimbursement schedule and the confidentiality provisions related to that data. Instead, it allows the assistant secretary to adopt rules and regulations for reimbursement amounts in the absence of a Medicare fee schedule. Furthermore, in disputes between healthcare providers and payors regarding reimbursement amounts, the bill stipulates that the prevailing party will be awarded reasonable attorney fees based on actual fees incurred. Overall, the bill seeks to streamline the reimbursement process and clarify the responsibilities of the involved parties.

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