Title 40
LABOR AND EMPLOYMENT
Part I. Workers' Compensation Administration
Subpart 2. Medical Guidelines
Chapter 27. Utilization Review Procedures
§2715. Medical Treatment Schedule Authorization and Dispute Resolution
A. - B.3. ...
C. Minimum Information for Request of Authorization
1. - 3.b. ...
4. The 1010 form approval may last longer than 30 days, especially if a treatment facility is closed because of COVID-19.
D. - O. ...
AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1203.1.
HISTORICAL NOTE: Promulgated by the Department of Employment and Training, Office of Workers' Compensation, LR 17:263 (March 1991), repromulgated LR 17:653 (July 1991), repromulgated LR 18:257 (March 1992), amended by the Louisiana Workforce Commission, Office of Workers' Compensation, LR 38:1030 (April 2012), repromulgated LR 38:1287 (May 2012), amended LR 38:3255 (December 2012), LR 40:1163 (June 2014), amended by the Louisiana Workforce Commission, Office of Workers' Compensation, LR 46:
Chapter 29. Pharmacy Reimbursement Schedule, Billing Instruction and Maintenance Procedures
Editor's Note: Other Sections applying to this Chapter can be found in Chapter 51.
§2901. Applicability
A. Emergency Rule shall apply to any and all Workers' Compensation insurance related entities licensed by the Department of Insurance, those defined as "carrier" in LAC 40:I.103, or doing business in Louisiana (collectively known as "workers' compensation insurers").
B. The assistant secretary or the secretary reserves the right to amend, modify, alter or rescind all or any portions of Emergency Rule.
C. If any section or provision of Emergency Rule is held invalid, such invalidity or determination shall not affect other sections or provisions, or the application of Emergency Rule, to any persons or circumstances that can be given effect without the invalid sections or provisions and the application to any person or circumstance shall be severable.
AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1203.1.
HISTORICAL NOTE: Promulgated by the Louisiana Workforce Commission, Office of Workers' Compensation, LR 46:
§2902. Effective Date
A. Emergency Rule shall become effective at 12:01 a.m. on March 19, 2020 and shall continue in full force and effect for the maximum time period allowed under the Administrative Procedure Act or for the period of the Governor's Stay-at Home Order, whichever shall end first.
AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1203.1.
HISTORICAL NOTE: Promulgated by the Louisiana Workforce Commission, Office of Workers' Compensation, LR 46:
§2903. Prescription Drug Coverage
A. Workers' compensation insurers shall allow insured individuals to obtain refills of their prescriptions even if the prescription was recently filled, consistent with approval from patients' health care providers and/or pharmacists. This provision does not apply to prescription drugs with a high likelihood of abuse, such as opioids that are restricted to 7-day prescriptions.
B. This authorization shall be for at least 30-day and up to 90-day supply, consistent with approval from patients' health care providers and/or pharmacists.
C. Mail order prescriptions should be mailed to an alternate address if requested by the insured.
AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1203.1.
HISTORICAL NOTE: Promulgated by the Louisiana Workforce Commission, Office of Workers' Compensation, LR 46:
§2904. Prior Authorizations or Restrictions
A. All workers' compensation insurers shall waive time restrictions on prescription medication refills, which include suspension of electronic "refill too soon" edits to pharmacies, to enable insureds or subscribers to refill prescriptions in advance, if there are authorized refills remaining.
B. All workers' compensation insurers shall authorize payment to pharmacies for at least a 30-day supply of any prescription medication, regardless of the date upon which the prescription had most recently been filled by a pharmacist, at any time when the state is declared to be under a state of emergency in an executive order issued by the governor and;
1. the prescription is not for a Schedule II medicinal drug;
2. the medication is essential to the maintenance of life or to the continuation of therapy in a chronic condition;
3. in the pharmacist's professional judgment, the interruption of therapy might reasonably produce undesirable health consequences or may cause physical or mental discomfort; or
4. the dispensing pharmacist notifies the prescriber of emergency dispensing within a reasonable time after such dispensing.
C. Pharmacist may refill most medications, one time, with a 30-day supply, even though the pharmacist cannot reach the patient's physician.
AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1203.1.
HISTORICAL NOTE: Promulgated by the Louisiana Workforce Commission, Office of Workers' Compensation, LR 46:
Inquiries concerning the proposed enactment may be sent to Assistant Secretary Sheral Kellar, OWC-Administration, 1001 North 23rd Street, Baton Rouge, LA 70802.