Senate Bill No. by Senator Myers seeks to amend Louisiana's workers' compensation laws by establishing the "All Workers' Compensation Medical Claims Database," which will be overseen by the assistant secretary of the office of workers' compensation administration. This database aims to enhance transparency in medical reimbursement trends, enforce fee schedules, and support policy development. Starting January 1, 2027, all workers' compensation payors will be required to submit detailed medical and pharmacy claims data, including elements such as the date of injury and provider specialty. The bill also mandates electronic submission of medical claims by October 1, 2026, and introduces a statewide electronic prior authorization portal to streamline medical care approvals.

Additionally, the bill updates the reimbursement schedule for medical services, requiring that reimbursement amounts be based on the 75th percentile of the Practice Management Information Corporation Medical Fees Directory and prohibiting "by report" billing. It includes provisions for timely responses to prior authorization requests, imposes civil fines on payors for late payments, and establishes a process for resolving billing disputes. The assistant secretary is tasked with ensuring compliance with these new requirements and developing a Workers' Compensation Medical Quality and Outcomes Program by January 1, 2031, to evaluate the quality of care provided to injured employees. Overall, the legislation aims to improve the efficiency and transparency of the workers' compensation system in Louisiana.

Statutes affected:
SB408 Original: 23:2(B), 23:1201(E), 23:1203(B), 44:1(B)(12)