Topics addressed included changes to the fee schedule, utilization review, spinal therapy guidelines, and more.
Topics addressed included changes to the fee schedule, utilization review, spinal therapy guidelines, and more.
The exemption reduces unnecessary burden and grows recognition that workers’ comp PBMs operate differently from traditional PBMs.
If enacted, House Bill 117 would trigger the first update to the Louisiana workers’ comp fee schedule in 30 years.
Topics discussed include proposals for a fee schedule by 2027, employer direction of care, and allowing more providers to provide disability opinions.
After previous drafts of new rules were withdrawn last year, a revised set of rules have been introduced, based on stakeholder feedback.
In addition to bill amendments, the bill has been deferred for one week to allow for additional review and stakeholder input.
The pilot test will run from April 24 to May 8, 2025, allowing stakeholders to provide feedback to the DWC.
Healthe attended the April 16th meeting, capturing key updates regarding the pharmacy fee schedule and drug formulary.
Filed in October 2024, the amendments aimed to adjust AWP discount rates and standardize dispensing fees.
The bill could require biennial updates, utilizing RVUs form the resource-based relative value scale (RBRVS).
The hybrid meeting will cover the pharmacy fee schedule, biosimilars, cannabis coverage, and payments for topical drugs.
These disputes would qualify for independent bill review, and contracts must be presented when justifying payments below fee schedule.
A hearing from the Committee on Economic Matters saw back and forth discussion but yielded no progress.
The medical fee schedule would align reimbursement rates with those of similar neighboring states.
The virtual meeting will take place April 1, 2025 at 10:00 AM to discuss outstanding issues related to the Health Care Provider Manual.
