The Louisiana Workforce Commission and the Office of Workers’ Compensation are working on updates to the hospital fee schedule in our state. Specifically, modifying the set charges for inpatient and outpatient procedures are at issue. The current hospital fee schedule provides for a per diem rate for inpatient services and a 90% reimbursement of the “usual and customary” charges for outpatient procedures – that standard has not changed since the 1990s, and the rise in the cost of outpatient services has led to much consternation, especially in the business community. WCRI recognized this issue in an April 22nd, 2014 report which cites outpatient fees as the most significant factor in Louisiana’s skyrocketing medical costs. Clark Cossé III, general counsel for the Louisiana Hospital Association, told WorkCompCentral that the new schedule is aimed to be a pay-per-code structure with set reimbursement rates for specific procedures, rather than a 90% standard.
Read the full overview from WorkCompCentral here.