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
(OWCA) medical director.
Proposed law retains present law but provides that if a conflict exists between any medical
director and any party to the appeal, OWCA shall 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, in accordance
with present law (R.S. 23:1203.1(C), that the treatment is appropriate.
(Amends R.S. 23:1203.1(J) and (M))
Summary of Amendments Adopted by House
Committee Amendments Proposed by House Committee on Labor and Industrial Relations to
the original bill.
1. Provided that if there is a conflict of interest between any party to the appeal and any
medical director, that OWCA shall contract with other medical directors.
2. Provided that when treatment is not covered by the medical treatment schedule,
payment is due by the employer when the employee can demonstrate to the medical
director, by preponderance of the scientific evidence, and in accordance with present
law, which provides for best available external clinical evidence from systematic
research, that treatment is appropriate.