§ 23:1291 — Creation, powers, and duties of the office of workers' compensation administration

§1291. Creation, powers, and duties of the office of workers' compensation administration
A. The office of workers' compensation administration is hereby established within
Louisiana Works to administer the provisions of this Chapter. The office shall be
administered by an assistant secretary, who shall be an assistant secretary appointed pursuant
to R.S. 36:307.
B. The assistant secretary shall have the following powers, duties, and functions:
(1) To supervise, direct, and account for the administration and operation of the
office, its sections, functions, and employees.
(2) To appoint such personnel as may be necessary for the administration and
operation of the office within such limitations as may be imposed by law.
(3) Repealed by Acts 1988, No. 938, §3, eff. July 1, 1989.
(4) To require, that every Louisiana employer of more than fifteen employees
provide, if self insured, or is provided by the insurer, if privately insured, plans for
implementation of a working and operational safety plan. The plans shall be made available
for inspection by the assistant secretary upon request but shall be privileged and confidential
pursuant to R.S. 23:1293 provided that the operational safety plan may be subpoenaed from
the employer who shall certify under oath that it is a duplicate of the plan submitted to the assistant secretary . In order to assure adequate safety resources for Louisiana employers and
employees, the assistant secretary shall maintain a list of safety engineers from the private
sector, which shall be available upon request by any Louisiana employer.
(5) To establish and promulgate in accordance with the Administrative Procedure
Act such rules and regulations governing the administration of this Chapter and the operation
of the office as may be deemed necessary and which are not inconsistent with the laws of this
state.
(6) To delegate any of his powers, duties, or functions to a manager of a section,
except his powers to remove employees of the office or to fix their compensation, and to
establish and promulgate rules and regulations.
(7) To review and approve "own-risk" applications.
(8) To monitor "own-risk" insurance programs in accordance with the rules of the
office of workers' compensation administration.
(9) To enforce the reimbursement schedule established for drugs, supplies, hospital
care and services, medical and surgical treatment, and any nonmedical treatment recognized
by the laws of this state as legal.
(10) To require the use of appropriate procedures, including a utilization review
process that establishes standards of review, for determining the necessity, advisability, and
cost of proposed or already performed hospital care or services, medical or surgical
treatment, or any nonmedical treatment recognized by the laws of this state as legal, and to
resolve disputes over the necessity, advisability, and cost of same.
(11) To engage the services of qualified experts in the appropriate health-care fields
to assist him in the discharge of his responsibilities in Paragraph (10) of this Subsection, and
to establish fees and promulgate rules and procedures in furtherance of his performance of
these duties.
(12) To audit the specific medical records of the patient under treatment by any
health care provider who has furnished services or treatment to a person covered by this
Chapter, or the records of any person or entity rendering care, services, or treatment or
furnishing drugs or supplies for the purpose of determining whether an inappropriate
reimbursement has been made.
(13) To promulgate necessary rules and regulations in accordance with the provisions
of the Administrative Procedure Act, imposing reasonable fines or penalties for a failure to
comply with any rule or regulation adopted under the provisions of this Chapter. In no event
shall such fine or penalty exceed five hundred dollars.
(14) To appoint an advisory council of five persons to consult with him periodically
upon the efficient administration of his responsibilities under this Chapter.
C. There shall be established within the office the following sections:
(1) A hearing section, the primary duty of which shall be to resolve and/or adjudicate
disputed claims filed with the office of workers' compensation administration.
(2) A medical service section, the primary duty of which shall be to administer and
implement the provisions of Paragraphs (B)(9), (10), (11), and (12) of this Section and R.S.
23:1121 through 1123.
(3) A workplace safety section, the primary duty of which shall be to administer and
implement the provisions of Paragraph (B)(4) of this Section, the OSHA 21(d)(1) program
and the Workers' Compensation Cost Containment Act. This section shall also have the
responsibility for the coordination of the safety programs of Louisiana Works.
(4) A records management section, which shall administer and implement the
provisions of R.S. 23:1201(H), 1292, 1306, 1310.10, and 1310.12.
(5) A workers' compensation fraud section, which shall administer the provisions of
R.S. 23:1170, 1171, 1171.1, 1172, 1172.1, 1172.2, 1208, and 1295 by investigating
allegations of workers' compensation fraud and noncompliance by employers.
(6) Repealed by Acts 2001, No. 627, §2.
D. Each section shall perform such other functions and duties as may be prescribed
by the assistant secretary and shall act under the direction and supervision of the assistant secretary .

Legislative History

Amended by Acts 1983, 1st Ex. Sess., No. 1, §1, eff. July 1, 1983; Acts 1988, No. 938, §1, eff. Jan. 1, 1989, and July 1, 1989; Acts 1989, No. 260, §1, eff. Jan. 1, 1990; Acts 1989, No. 512, §1, eff. Jan. 1, 1990; Acts 1989, No. 530, §1; Acts 1991, No. 892, §1; Acts 1992, No. 447, §1, eff. June 20, 1992; Acts 1992, No. 763, §1; Acts 1992, No. 794, §1; Acts 1995, No. 246, §1, eff. June 14, 1995; Acts 1997, No. 88, §§1, 2, eff. June 11, 1997; Acts 1997, No. 89, §1, eff. June 11, 1997; Acts 1997, No. 1172, §4, eff. June 30, 1997; Acts 2001, No. 627, §§1 and 2; Acts 2005, No. 257, §1; Acts 2008, No. 743, §7, eff. July 1, 2008; Acts 2014, No. 375, §1.