Louisiana 2024 Regular Session

Louisiana House Bill HB870

Introduced
4/2/24  
Refer
4/3/24  

Caption

Provides for adoption of a medical fee reimbursement schedule for workers' compensation

Impact

The legislation is expected to significantly impact the financial dynamics of workers' compensation claims by establishing a more standardized reimbursement framework. By shifting the basis for reimbursement calculations toward the Medicare fee schedule, the bill aims to enhance predictability in compensation payments. This could help reduce disputes between healthcare providers and payors, as the bill also specifies that the burden of proof regarding reimbursement amounts lies with the party seeking payment. Such changes could have broader implications for healthcare providers and the operations of the workers' compensation system, leading to both opportunities and challenges in claims processing.

Summary

House Bill 870, introduced by Representative Echols, aims to establish and clarify a reimbursement schedule for medical fees related to workers' compensation claims in Louisiana. The bill proposes to amend existing laws governing how reimbursement amounts for various healthcare services and treatments are determined. Specifically, it sets forth that reimbursements will either be capped at a multiplier of one and a half times the Medicare fee schedule or will be limited to the actual charge made for the service, whichever amount is less. This transition is intended to streamline the reimbursement process and provide clearer guidelines for reimbursement calculations across the state.

Sentiment

Overall, the sentiment surrounding HB 870 appears to be cautiously optimistic among supporters who see it as a necessary reform for improving the efficacy of workers' compensation claims management. Proponents believe that this legislation will protect healthcare providers from unreasonable payment disputes while ensuring that patients receive the necessary care without undue financial burden. However, some concerns linger about potential impacts on reimbursement fairness and the adequacy of compensation for certain services, particularly in cases where the Medicare fee schedule may be viewed as insufficient.

Contention

Notable points of contention regarding this bill center on the elimination of authority for the assistant secretary of the office of workers' compensation to collect certain pricing information, which was previously aimed at ensuring transparency. Critics argue that this could compromise efforts to maintain fair provider reimbursement practices and protect consumer interests. Additionally, the potential for increased disputes regarding the interpretation of what constitutes reasonable charges poses challenges. The provision for awarding reasonable attorney fees to the prevailing party in reimbursement disputes may also stir discussions on the practicality and implications of legal battles in the healthcare ecosystem.

Companion Bills

No companion bills found.

Previously Filed As

LA HB493

Provides for fees on emergency ground ambulance providers and the disposition of fees (EN INCREASE SD RV See Note)

LA SB135

Provides relative to Medicaid reimbursement for services provided by a licensed midwife or certified nurse midwife. (8/1/23) (EN +$39,972 GF EX See Note)

LA SB109

Provides for balance billing by and reimbursement of covered health services provided by out-of-network emergency ambulance services. (8/1/23) (EN INCREASE SG EX See Note)

LA HB1

Provides for the ordinary operating expenses of state government for Fiscal Year 2023-2024

LA HB596

Creates the Louisiana Family and Medical Leave Benefits Act (OR +$32,986,100 GF EX See Note)

LA HB508

Provides relative to the exclusion of Medicaid reimbursement from certain revenues

LA SB104

Provides for health insurance coverage of genetic testing for diseases and other medical conditions. (8/1/23) (EN INCREASE GF EX See Note)

LA SB14

Provides relative to schedules of the Uniform Controlled Dangerous Substances Law. (8/1/23)

LA HB641

Provides for the termination of certain tax exemptions, exclusions, credits, deductions, and other tax incentives (EG INCREASE GF RV See Note)

LA SB200

Provides that retaliation against an employee for an absence from work due to genetic testing or a medically necessary cancer screening shall be an unlawful employment practice. (8/1/23)

Similar Bills

LA SB213

Provides for preliminary determination hearings in workers' compensation. (1/1/27)

LA HB863

Provides for adoption of a medical fee reimbursement schedule for workers' compensation (RE +$200,000 SD EX See Note)

LA HB117

Provides for adoption of a medical fee reimbursement schedule for workers' compensation (EG +$100,000 SD EX See Note)

LA HB198

Provides for adoption of a medical fee reimbursement schedule for workers' compensation (OR DECREASE EX See Note)

CA SB748

Disability access and information: local government: notice.

NJ SCR57

Requests President and Congress to take action to permit federal Medicaid funding for certain substance use disorder programs.

NJ SCR85

Requests President and Congress take action to permit federal Medicaid funding for certain substance use disorder programs.

IL SB3413

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