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)]
Ivey HB No. 450
Abstract: Provides alternatives for cases in which there exist conflicts with the medical director
or cases in which the recommended treatment is not outlined specifically in the medical
treatment guidelines.
Present law provides procedure for submitting claims for workers' compensation reimbursement.
Present law (R.S. 23:1203.1(J)) provides that if a dispute arises regarding medical care, the
aggrieved party shall file an appeal with the office of workers' compensation administration
medical director.
Proposed law retains present law but provides that if a conflict exists between the medical
director and any party to the appeal, the office of workers' compensation administration may
contract with other medical directors.
Proposed law requires that in the event of a conflict described in proposed law, the alternate
medical director(s) shall render a decision within 30 calendar days.
Present law (R.S. 23:1203.1(M)) provides that all medical treatment not covered by the medical
treatment schedule shall be in accordance with present law (R.S. 23:1203.1(D)).
Present law (R.S. 23:1203.1(D)) provides that medical treatment guidelines shall be based on the
following criteria:
(1) Rely on specified, comprehensive, and ongoing systematic medical literature review.
(2) Contain published criteria for rating studies and for determining the overall strength of the
medical evidence, including the size of the sample, whether the authors and researchers had any
financial interest in the product or service being studied, the design of the study and
identification of any bias, and the statistical significance of the study.
(3) Are current and the most recent version produced, which shall mean that documented
evidence can be produced or verified that the guideline was developed, reviewed, or revised
within the previous five years.
(4) Are interdisciplinary and address the frequency, duration, intensity, and appropriateness of
treatment procedures and modalities for all disciplines commonly performing treatment of employment-related injuries and diseases.
(5) Are, by statute or rule, adopted by any other state regarding medical treatment for workers'
compensation injuries, diseases, or conditions.
Proposed law retains present law and further provides that in instances in which a treatment is
not covered by the medical treatment schedule, the employer is liable to pay when it has been
demonstrated by a preponderance of scientific evidence to the medical director, through
submission of scientific medical literature that the treatment is appropriate.
(Amends R.S. 23:1203.1(J) and (M))