HB 819

HLS 26RS-1128  REENGROSSED
     2026 Regular Session
     HOUSE BILL NO. 819
     BY REPRESENTATIVE CREWS
     WORKERS COMPENSATION: Provides relative to the medical treatment schedule under
  workers' compensation
 1  AN ACT
 2   To amend and reenact R.S. 23:1203.1(A)(introductory paragraph) and (6), (B), and (M) and
 3  to repeal R.S. 23:1203.1(C) through (I) and (O), relative to workers' compensation;
 4  to revise the workers' compensation medical treatment schedule; to require payment
 5  of certain invoices concerning the medical treatment schedule; to provide for the
 6  inclusion of the Official Disability Guidelines as the medical treatment schedule
 7  under workers' compensation; to provide for burden of proof; to revise a definition;
 8  to provide for the revision and promulgation of the medical treatment schedule after
 9  a certain period of time; and to provide for related matters.
10   Be it enacted by the Legislature of Louisiana:
11  Section 1. R.S. 23:1203.1(A)(introductory paragraph) and (6), (B), and (M) are
12   hereby amended and reenacted to read as follows:
13  §1203.1. Definitions; medical treatment schedule; medical advisory council
14  A. For use in this Section, the following terms have the following meanings,
15  unless clearly indicated otherwise by the context For the purpose of this Section,
16  unless clearly indicated otherwise by the context, the following terms have the
17  meanings ascribed to them:
18  *       *  *
19  (6)(a) "Schedule" means the medical treatment schedule to be developed by
20  the council and promulgated by the office and the assistant secretary or the Official
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 1  Disability Guidelines (ODG) by MCG, which are evidence-based, medical treatment
 2  that is delivered and consistent with either the schedule promulgated by the office
 3  and the assistant secretary or a schedule utilizing the ODG.
 4  (b) The schedule shall be tacitly approved and not be subject to prior
 5  authorization by the employer.
 6  *       *  *
 7  B.(1) The employer shall pay any invoice of the medical provider that is
 8  consistent with the schedule, net thirty days of the invoice.
 9  (2) The employer may challenge the delivery of care consistent with the
10  schedule. The employer shall show, by clear and convincing evidence, that the care
11  was not medically necessary. The assistant secretary shall, through the office of
12  workers' compensation administration, promulgate rules in accordance with the
13  Administrative Procedure Act, R.S. 49:950 et seq., to establish a medical treatment
14  schedule.
15  (1) Such rules shall be promulgated no later than January 1, 2011.
16  (2) The medical treatment schedule shall meet the criteria established in this
17  Section and shall be organized in an interdisciplinary manner by particular regions
18  of the body and organ systems.
19  *       *  *
20  M.(1) With regard to all treatment not covered by the medical treatment
21  schedule promulgated in accordance with this Section, all medical care, services, and
22  treatment shall be in accordance with Subsection D of this Section. With regard to
23  all treatment not covered in the Official Disability Guidelines (ODG) by MCG, all
24  medical care, services, and treatment shall do all of the following:
25  (1) Rely on specified, comprehensive, and ongoing systematic medical
26  literature review.
27  (2) Contain published criteria for rating studies and for determining the
28  overall strength of the medical evidence, including the size of the sample, whether
29  the authors and researchers had any financial interest in the product or service being
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 1  studied, the design of the study and identification of any bias, and the statistical
 2  significance of the study.
 3  (3) Be the current and most recent version produced, which shall mean the
 4  documented evidence can be produced or verified that the guideline was developed,
 5  reviewed, or revised within the previous five years.
 6  (4) Be interdisciplinary and address the frequency, duration, intensity, and
 7  appropriateness of treatment procedures and modalities for all disciplines commonly
 8  performing treatment of employment-related injuries and diseases.
 9  (5) Be, by statute or rule, adopted by any other state regarding medical
10  treatment for workers' compensation injuries, diseases, or conditions.
11  (2) Notwithstanding any other provision of this Chapter, all treatment not
12  specified in the medical treatment schedule and not found in Subsection D of this
13  Section shall be due by the employer when it is demonstrated to the medical director,
14  in accordance with the principles of Subsection C of this Section, that a
15  preponderance of the scientific medical evidence supports approval of the treatment
16  that is not covered.
17  *        *        *
18  Section 2. R.S. 23:1203.1(C) through (I) and (O) are hereby repealed in their
19   entirety.
20  Section 3.(A) If, after two years from the enactment of this Act, there is not a
21   reduction of the average costs of medical care, services, and treatment under the updated
22   medical treatment schedule, which is in conjunction with the Official Disability Guidelines,
23   as amended and reenacted by Section 1 of this Act, the medical treatment schedule shall be
24   developed by the medical advisory council and promulgated by the office of workers'
25   compensation administration and its assistant secretary.
26  (B) The assistant secretary of the office of workers' compensation administration
27   shall promulgate any necessary rules in accordance with the Administrative Procedure Act
28   to establish the medical treatment schedule.
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HLS 26RS-1128  REENGROSSED
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  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 819 Reengrossed  2026 Regular Session  Crews
Abstract: Revises the workers' compensation medical treatment schedule to provide for the
      inclusion of the Official Disability Guidelines (ODG) by MCG.
Present law defines certain terms.
Proposed law revises the definition of "schedule" to instead provide that "schedule" means
the medical treatment schedule to be developed by the council and promulgated by the office
and the assistant secretary or the Official Disability Guidelines (ODG) by MCG, which are
evidence-based, medical treatment that is delivered and consistent with either the schedule
promulgated by the office and the assistant secretary or a scheduled utilizing ODG.
Proposed law requires the schedule to be tacitly approved and not subject to prior
authorization by the employer.
Present law requires the assistant secretary, through the office of workers' compensation
administration (OWCA), to promulgate rules in accordance with present law (R.S. 49:950
et seq.) to establish a medical treatment schedule.
Present law requires the rules to be promulgated by a certain date.
Present law requires that the medical treatment schedule to meet the criteria established in
present law and be organized in an interdisciplinary manner by particular regions of the body
and organ systems.
Proposed law require the employer to pay any invoice of the medical provider that is
consistent with the schedule, net 30 days of the invoice.
Proposed law allows the employer to challenge the delivery of care consistent with the
schedule. Proposed law requires the employer to prove, by clear and convincing evidence,
that the care was not medically necessary.
Present law provides that with regard to all treatment not covered by the medical treatment
schedule promulgated in accordance with present law (R.S. 49:950 et seq.), all medical care,
services, and treatment shall be in accordance with present law (R.S. 23:1203.1(D)).
Proposed law instead provides that with regard to all treatment not covered in the ODG, all
medical care, services, and treatment shall do all of the following:
(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)    Be the current and most recent version produced, which shall mean the documented
       evidence can be produced or verified that the guideline was developed, reviewed, or
       revised within the previous five years.
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HLS 26RS-1128  REENGROSSED
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(4)    Be 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)    Be, by statute or rule, adopted by any other state regarding medical treatment for
       workers' compensation injuries, diseases, or conditions.
Present law provides that all treatment not specified in the medical treatment schedule and
not found in present law (R.S. 23:1203.1(D)) shall be due by the employer when it is
demonstrated to the medical director, in accordance with present law (R.S. 23:1203.1(C)),
that a preponderance of the scientific medical evidence supports approval of the treatment
that is not covered.
Proposed law repeals present law.
Present law requires the schedule to be developed by the conscientious, explicit, and
judicious use of current best evidence in making decisions about the care of individual
patients, integrating clinical expertise, which is the proficiency and judgment that clinicians
acquire through clinical experience and clinical practice, with the best available external
clinical evidence from systematic research.
Present law requires the medical treatment schedule to be based on guidelines that shall meet
all of 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, 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.
Present law requires the medical advisory council to develop guidelines in accordance with
present law and allows the council to amend the schedule in accordance with present law
before submission to the assistant secretary for initial and subsequent formal adoption and
promulgation.
Present law requires the assistant secretary to appoint a medical advisory council, which
shall be selected in accordance with the following:
(1)    The professional association in La. that represents each discipline enumerated in
       present law shall provide the assistant secretary with the names of three nominees,
       from which at least one representative shall be chosen to represent his respective
       discipline on the council.
(2)    The assistant secretary shall select at least one representative from certain medical
       disciplines or associations.
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(3)    The assistant secretary may consider and appoint additional representatives in order
       to fulfill his duties as defined in present law.
(4)    The initial members of the medical advisory council shall serve until a date specified
       in present law, and all subsequent members shall serve two-year terms beginning on
       Aug. 15th of each odd-numbered year.
(5)    The assistant secretary shall have the authority to contract with a medical director
       and with consultants to assist the assistant secretary and the medical advisory council
       in the establishment and promulgation of the schedule.
Present law provides the responsibilities of the medical advisory council.
Present law provides that the assistant secretary, with the assistance of the medical advisory
council, is authorized to review and update the medical treatment schedule at least once
every two years. Present law further provides that any updates shall be made by rule
promulgation.
Present law provides that after the promulgation of the medical treatment schedule, medical
care, services, and treatment due, pursuant to present law (R.S. 23:1203 et seq.) by the
employer to the employee shall mean care, services, and treatment in accordance with the
medical treatment schedule.
Present law provides that medical care, services, and treatment that vary from the
promulgated medical treatment schedule shall also be due by the employer when it is
demonstrated to the medical director by a preponderance of the scientific medical evidence
that a variance from the medical treatment schedule is reasonably required to cure or relieve
the injured worker from the effects of the injury or occupational disease, given the
circumstances.
Present law provides that no member of the medical advisory council, who is acting within
the scope of his official functions and duties, shall be held individually liable for a policy
recommendation or policy action by the council, unless damage or injury is caused by the
member's willful or wanton misconduct.
Present law provides a person immune from liability under the provisions of present law
(R.S. 23:1203.1(O)(1)) shall not be subject to civil or administrative subpoena for his
recommendations or exercise of judgment as a member of the council, including a subpoena
seeking his oral or written testimony at trial, discovery, or other proceeding, and a subpoena
duces tecum seeking documents, inspections, things or information in electronic or any other
form.
Proposed law repeals present law.
Proposed law provides that if, after two years from the enactment of proposed law, there is
not a reduction of the average costs of medical care, services, and treatment under the
updated medical treatment schedule as provided for in proposed law, the medical
reimbursement schedule shall be developed by the medical advisory council and
promulgated by the OWCA and the assistant secretary of the OWCA.
Proposed law requires the assistant secretary of OWCA to promulgate any necessary rules
to establish the medical treatment schedule.
(Amends R.S. 23:1203.1(A)(intro. para.) and (6), (B), and (M); Repeals R.S. 23:1203.1(C)-
(I) and (O))
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HLS 26RS-1128  REENGROSSED
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Summary of Amendments Adopted by House
   The Committee Amendments Proposed by House Committee on Labor and Industrial
  Relations to the original bill:
   1.     Revise the definition of "schedule".
   2.     Require the employer to pay any invoice of the medical provider that is
  consistent with the schedule, net thirty days of the invoice.
   3.     Allow the employer to challenge the delivery of care consistent with the
  schedule.
   4.     Require the employer to show by clear and convincing evidence that the care was
  not medically necessary.
   5.     Provide that if there is not a reduction of certain costs under the updated medical
  treatment schedule as provided for in proposed law then, after two years from the
  enactment of proposed law, the medical treatment schedule shall be developed
  by the medical advisory council and promulgated by the office of workers'
  compensation administration and its assistant secretary.
   6.     Make title and technical changes.
   The House Floor Amendments to the engrossed bill:
   1.     Make title changes.
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