The first Workers’ Compensation Advisory Council (WCAC) meeting of 2019 was held yesterday at the LaSalle Building in Baton Rouge. Members discussed ongoing projects like the Medical Treatment Guidelines updates and the upcoming Legislative Session, which starts April 8th.
Closed Pharmacy Formulary Debate Begins Anew
Assistant Secretary and WCAC Chair Sheral Kellar indicated to the Council and public that a closed pharmacy formulary bill could be filed in the upcoming Legislative Session, despite the fact that it is a fiscal-only session. “The Louisiana Property and Casualty Insurance Commission had a meeting where it recommended that legislation be submitted to have a closed pharmacy formulary in workers’ compensation,” Kellar explained. “I just wanted to make you guys aware, I don’t know if there is a sponsor for the bill yet.”
On the heels of this, Kellar shared a document from the Kaiser Family Foundation indicating that Louisiana is No. 35 among all states and D.C. for opioid-related deaths, at 9.3 deaths per 100,000 individuals. This puts us at the bottom of the list, implying that state efforts to stem the tide of the opioid crisis are working.
Act 257 Revisions for Prescriptive Period Still in Limbo
The Council is still working on reviving a piece of legislation offered up by Representative Gaines in the 2018 Legislative Session that would create a deadline to appeal the decision of the Medical Director. This would cut down on temporary disability benefits and potentially get injured workers back to work faster. “There is no prescriptive period for decisions of the Medical Director to the workers’ compensation judge,” Kellar explained. “Because there’s an absence of appeal delay in the statute, the Supreme Court has interpreted that to mean that we go to the general prescriptive period of three years. If we want to pursue the purpose of the Medical Treatment Guidelines three years is too long.”
Both 15 day and 30 day periods have been considered, and Kellar is attempting to get a meeting with legislators to file something in the upcoming Session. There will be a meeting for stakeholders on the proposals on February 4th at 10 AM at the Louisiana Workforce Commission Annex Building. Kellar said she invites attendance or written comments.
Barber Remains Alive
Charles Davoli, WCAC Vice Chair, stated that writs have been filed in the Barber case to the Louisiana Supreme Court; they have not been rejected or accepted as of yet. Davoli also warned that “another constitutional challenge is brewing” over the exclusion of workers’ comp from Louisiana’s fledgling medical marijuana program. He identified it as an equal protection issue.
Davoli Offers Proposal for Consolidation of IME Statutes
Davoli distributed a lengthy document (see linked PDF at the bottom of this page) addressing his idea to consolidate LA. R.S. 23:1123 and 23:1124.1, the parts of the workers’ compensation statute that address how IME doctors are selected. The Office of Workers’ Compensation Administration would like to move away from having the Medical Services Division assign doctors for independent medical examinations because they are often unaware of the doctors’ specialities and other details. The Council has previously discussed having all IMEs assigned by the Workers’ Compensation Judges because they are better equipped to choose appropriate doctors in each case. Kellar stated that the judges and mediators recently met at the OWC educational conference last week and seemed to understand the issue.
Medical Treatment Guideline Updates Moving Forward
The Chronic Pain Guideline update that has been pending an official Notice of Intent (NOI) for several months is almost ready to be filed with the Louisiana Register, according to Kellar and OWCA Medical Director Dr. Jason Picard. Picard spoke to the Council, explaining that the Medical Advisory Council (MAC), which is responsible for the updates, added a bibliography of the medical evidence used to the end of the update, in response to stakeholder comments. The NOI is expected within the next month. Meanwhile, the MAC is concluding the Complex Regional Pain Syndrome Guideline as well.
The next WCAC meeting will take place at the LaSalle Building on February 28th. Assistant Secretary Kellar noted that there are two vacancies on the Council currently: one representing the state medical society, and another representing the orthopedic association. Phillip Hunter, a plaintiff’s attorney representing workers’ comp claimants for part of his practice, has recently joined the Council.
WCAC members present: Kellar, Davoli, Zimmerman, Stokes, Hunter, Morris, Losavio, Lindsey, Cherry
WCAC members absent: Kruse, Perkins, Murray, Jones, Williams, Dartez