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

House Bill 357 amends Louisiana Revised Statutes 23:1034.2 to establish a revised framework for the medical fee reimbursement schedule in workers' compensation claims. The bill modifies the standard by which the assistant secretary of the office of workers' compensation administration establishes reimbursement rates, changing from a mean of usual and customary charges to a requirement that rates be reasonable when compared to workers' compensation reimbursement schedules in surrounding states with similar characteristics. The assistant secretary is directed to promulgate an initial reimbursement schedule effective January 1, 2027, and any annual adjustments must be supported by data and information collected according to specified guidelines. The bill also creates new statutory duties requiring the assistant secretary to examine potential administrative and procedural relief for healthcare providers, evaluate paperwork reduction processes, explore processes to expand medical markets for increased patient access, and include external stakeholders and partners in calculating the schedule.

The practical effect of this legislation impacts healthcare providers participating in Louisiana's workers' compensation system, the employers and insurers who pay these claims, and injured workers seeking medical treatment. Healthcare providers will have reimbursement rates benchmarked against regional standards rather than historical usual and customary charges, potentially resulting in rate adjustments upward or downward depending on comparative analysis. The bill requires the assistant secretary to examine administrative efficiency measures and paperwork reduction, which may streamline claims processing and payment procedures for providers. Employers and insurers will need to adjust their claim payment processes to conform to the new reimbursement schedule once it takes effect. Workers may experience changes in healthcare provider availability and treatment access depending on how reimbursement rates affect provider participation in the workers' compensation system.

This legislation operates within the existing workers' compensation statutory framework established in Title 23 of the Louisiana Revised Statutes. The bill preserves the assistant secretary's authority to establish reimbursement schedules while modifying the methodology and criteria used in that process. The requirement for comparative analysis with surrounding states' workers' compensation schedules reflects a regional benchmarking approach rather than the internal mean-based calculation in present law. The bill maintains existing data collection guidelines requiring minimum thresholds of healthcare provider reporting, confidentiality protections to prevent identification of individual provider pricing, and aggregation standards. The quarterly reporting requirement to the House and Senate committees on labor and industrial relations creates a legislative oversight mechanism ensuring the rate study process remains subject to legislative review and potential intervention during the implementation period.