The original instrument and the following digest, which constitutes no part of the
legislative instrument, were prepared by Carla S. Roberts.
DIGEST
SB 160 Original 2020 Regular Session Talbot
Present law requires that the office of workers' compensation (OWC) develop a medical treatment
schedule, or guidelines, as to when and in what manner injured workers are to receive medical
treatment for injuries which are subject to coverage under workers' compensation policies. Present
law further provides that the OWC review and promulgate rules and regulations to ensure proper
medical care for the injured worker.
Proposed law retains present law and expands it by requiring the establishment of a prescription drug
formulary to be promulgated by January 1, 2021.
Proposed law requires the following:
(1)For claims in which the date of injury takes place on or after January 1, 2021, the formulary
will be utilized.
(2)For claims in which the date of injury takes place prior to January 1, 2021, the formulary will
be utilized for all refills and new prescriptions prescribed or dispensed for outpatient use on
and after July 1, 2021.
Proposed law requires that the promulgation of the formulary use the same criteria as used for the
development of the medical treatment guidelines. As it relates to the formulary, however, proposed
law provides that the OWC assistant secretary may adopt an existing formulary. Proposed law further
provides that, in determining which formulary to adopt, the assistant secretary shall consider the
following factors:
(1)Whether the formulary is written for specifically for workers' compensation.
(2)Whether the formulary includes measures to aid in the management of opioid medications.
(3)Whether the formulary appropriately limits both the duration and the dosage of prescriptions.
(4)The cost of implementation of the formulary.
(5)Whether the formulary is self-updating.
Proposed law provides that the formulary shall be updated when deemed necessary by the OWC
assistant secretary.
Proposed law provides that any prior authorization of a pharmacy or healthcare provider dispensing prescription medications, regardless of classification or lack of classification, shall be in accordance
with certain provisions of present law (R.S. 23:1142).
Present law provides that, if the treatment required by the injured worker is not sufficiently
addressed by the medical treatment schedule, the employer may demonstrate by preponderance of
the scientific medical evidence that a variance is necessary.
Proposed law retains present law and further requires that the formulary will also be subject to a
variance pursuant to the procedures in present law.
Effective August 1, 2020.
(Amends R.S. 23:1203.1(A)(4)(5) and (6), (B), (D)(intro para), (H), (I), (J)(1), (L), and (M)(1); adds
R.S. 23:1203.1(A)(7) and (M)(3) and (4))