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Regular Session, 2012
HOUSE BILL NO. 498
BY REPRESENTATIVE DIXON
WORKERS COMPENSATI ON: Provides for access to data from workers' compensation
insurers for fraud detection
AN ACT1
To amend and reenact R.S. 23:1293(A)(1) and to enact R.S. 23:1291.2, relative to workers'2
compensation; to provide that payors shall make certain information available; to3
provide for confidentiality; and to provide for related matters.4
Be it enacted by the Legislature of Louisiana:5
Section 1. R.S. 23:1293(A)(1) is hereby amended and reenacted and R.S. 23:1291.26
is hereby enacted to read as follows:7
§1291.2. Access to payors' records; fraud identification8
A. Each payor, as defined by R.S. 23:1142, shall make his claims and9
payment data, if such data are maintained, available to the office of workers'10
compensation administration for the purpose of identifying violations of this11
Chapter.12
B. The director of the office of workers' compensation administration may13
designate the data to be reproduced, copied, or utilized at his discretion to verify that14
employers and claimants are not engaging in fraudulent activities. Notwithstanding15
any other provision of law to the contrary, any data produced or inspected pursuant16
to this Section shall remain confidential and privileged and are not subject to17
discovery or subpoena in any legal proceeding, except in the prosecution of persons18
or corporations according to R.S. 23:1170, et seq. The Louisiana Workforce19 HLS 12RS-683 REENGROSSED
HB NO. 498
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Commission shall have the authority to promulgate rules and regulations necessary1
to implement the provisions of this Section.2
* * *3
§1293. Confidentiality of records; exceptions; penalties for violation4
A.(1) All medical records of an employee, all records of payment of5
compensation to an employee or his dependent, all records with respect to the6
rehabilitation or attempted rehabilitation of an injured employe e, all employer7
reports of injury as required by R.S. 23:1306, all claims by an employee or his8
dependent filed pursuant to R.S. 23:1310, records submitted to the Louisiana9
Workers' Compensation Second Injury Board concerning claims for reimbursement10
arising out of a claim by an employee or his dependent filed pursuant to Chapter 1011
of this Title, including but not limited to any and all records submitted for requests12
for reimbursement, documents maintained in the claim files regarding13
reimbursement and settlement requests, and all records submitted pursuant to R.S.14
23:1378(A)(7) 23:1378(A)(5), all safety plans pursuant to R.S. 23:1291(B)(4), and15
all safety records of the OSHA section obtained in connection with the Insurance16
Cost Containment Act or the OSHA 7(c)(1) program, and all data produced pursuant17
to R.S. 23:1291.2, shall be confidential and privileged, shall not be public records,18
and shall not be subject to subpoena, except that records of the office may be19
produced in response to an order of a workers' compensation judge based upon his20
finding that the record is relevant and necessary to the resolution of a disputed claim21
pending before the office. Such confidentiality and privilege shall be strictly22
maintained by the director and all employees of the office except as provided above23
or in Subsection B of this Section and shall be used exclusively for the purpose of24
discharging the duties and responsibilities of the office under this Chapter.25
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DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Dixon HB No. 498
Abstract: Requires that a payor responsible for the payment of the medical expenses
incurred as a result of a work related injury shall give the office of workers'
compensation administration (OWCA) access to certain records for fraud detection.
Proposed law provides that any payor responsible for the payment of the medical expenses
incurred by a claimant as a result of a work related injury shall make his records available
to the OWCA for review.
Proposed law provides that the data will remain confidential and is not subject to subpoena
or discovery in any legal proceeding, except as otherwise provided by law.
Proposed law authorizes LWC to promulgate rules and regulations necessary to carry out the
provisions of proposed law.
Proposed law allows the director of the OWCA to review and reproduce the data at his
discretion to verify that employers and claimants are free from fraudulent activities.
Present law provides for the confidentiality of workers' compensation records.
Present law provides that all data produced pursuant to present law and all safety records
relative to the Insurance Cost Containment Act or the OSHA 7(c)(1) program shall be
confidential and privileged.
Proposed law adds proposed law to the records that shall be confidential and privileged.
(Amends R.S. 23:1293(A)(1); Adds R.S. 23:1291.2)
Summary of Amendments Adopted by House
Committee Amendments Proposed by House Committee on Labor and Industrial
Relations to the original bill.
1. Changed the terms "insurers and self-insured employers" to "payors".
2. Changed the director's ability to examine records from the ability to examine
records and databases to verify that an insurer or self-insured employer is not
engaging in fraudulent activity to the ability to examine currently maintained
claims and payment data to ensure that employers and claimants are not engaging
in fraudulent activity.