HLS 19RS-790 ORIGINAL
2019 Regular Session
HOUSE BILL NO. 571
BY REPRESENTATIVE SEABAUGH
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
WORKERS COMPENSATION: Provides with respect to plastic and metallic implants or
non-autogenous graft
1 AN ACT
2To enact R.S. 23:1203.1.2, relative to workers' compensation; to provide with respect to the
3 reimbursement schedule; to provide for plastic and metallic implant or non-
4 autogenous graft; to require the purchase of implant or non-autogenous graft; to
5 provide for reimbursement; and to provide for related matters.
6Be it enacted by the Legislature of Louisiana:
7 Section 1. R.S. 23:1203.1.2 is hereby enacted to read as follows:
8 ยง1203.1.2. Duty to reimburse health facilities; implant or non-autogenous graft
9 A. When an injured worker requires and is entitled to a procedure that
10 necessitates the use of a plastic and metallic implant or non-autogenous graft, the
11 facility, hospital, or ambulatory surgery center, shall order and purchase the plastic
12 and metallic implant or non-autogenous graft.
13 B. Reimbursement for the plastic and metallic implant or non-autogenous
14 graft shall be at the manufacturer's original invoice amount, exclusive of rebates and
15 discounts, plus twenty percent.
16 C. The facility shall submit to the payor an original manufacturer's invoice
17 detailing the amount paid by the facility, hospital, or ambulatory surgery center for
18 the plastic and metallic implants or non-autogenous graft. The facility, hospital, or
19 ambulatory surgery center shall act as a prudent buyer and is answerable for any
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HLS 19RS-790 ORIGINAL
HB NO. 571
1 costs that exceed what a reasonable cost-conscious buyer would have paid for the
2 given item or service.
3 D. In the absence of clear and convincing evidence that the higher costs were
4 unavoidable, then the facility, hospital, or ambulatory surgery center shall not be
5 reimbursed for the excess costs.
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)]
HB 571 Original 2019 Regular Session Seabaugh
Abstract: Allows healthcare providers who purchase plastic and metallic implant's or non-
autogenous graft's to be reimbursed for reasonable cost of the implants.
Present law provides that the assistant secretary of the office of workers' compensation shall
establish and promulgate a reimbursement schedule for drugs, supplies, hospital care and
services, medical and surgical treatment, and any non-medical treatment recognized by
present law, the Workers' Compensation Act.
Proposed law retains present law to add that the facility, hospital or ambulatory surgery
center, must order and pay for the implant or non-autogenous graft and upon receipt of the
original manufacturer's invoice, shall be reimbursed by the payor.
Proposed law provides that the reimbursed amount shall be at the manufacturer's original
invoice amount, exclusive of rebates and discounts, plus 20%.
Proposed law provides that the costs associated with the purchasing of an implant or non-
autogenous graft shall not exceed what a prudent buyer pays for an item or service of its
kind.
Proposed law provides that if costs of the implant or non-autogenous graft should exceed the
level of a prudent buyer then the amount in excess shall not be reimbursed.
(Adds R.S. 23:1203.1.2)
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.