1. A. The Louisiana Workers' Compensation Statutes (R.S. 23:1142) establishes a monetary limit for nonemergency medical care. The statute further provides significant penalties for a carrier/self-insured employer's arbitrary and capricious refusal to approve necessary care beyond that limit. (See Chapter 27 Utilization Review Procedures, §2715.A and B). In addition to all other rules and procedures, the provider or practitioner who provide care under the "medical emergency" exception must demonstrate that it was a "medical emergency" as outlined in the Utilization Review Procedures, cited above. For additional instructions, please refer to the respective section of the schedule.

Authority Note

AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1034.2.

Historical Note

HISTORICAL NOTE: Promulgated by the Department of Labor, Office of Workers' Compensation, LR 19:54 (January 1993), repromulgated LR 19:212 (February 1993), amended LR 20:1299 (November 1994).

Editor’s Note: In addition, the following Sections of this Chapter are applicable and shall be used for the other chapters in this Part governing reimbursement. These specific Chapters are: Chapter 31, Vision Care Services; Chapter 33, Hearing Aid Equipment and Services; Chapter 35, Nursing Attendant Care and Home Health Services; Chapter 39, Medical Transportation; Chapter 41, Durable Medical Equipment and Supplies; Chapter 43, Prosthetic and Orthopedic Equipment; Chapter 45, Respiratory Services; Chapter 47, Miscellaneous Claimant Expenses; and Chapter 49, Vocational Rehabilitation Consultant.