Judge Issues Permanent Injunction Enjoining Practical Effect of Louisiana Medical Treatment Guidelines and Appeal ProcedureIn a significant development impacting the Louisiana Workers' Compensation medical claims process, on March 2, 2017, a Louisiana District Court Judge in East Baton Rouge Parish issued a judgment in the case of Janice Hebert Barber, et al. v. Louisiana Workforce Commission, et al., 19th Judicial District Court, Docket No.: 621,071, Sec. 26, permanently and broadly enjoining, in general and also specific portions of the relevant statutes and regulations of the Louisiana Medical Treatment Guidelines ("MTG") process from being enforced by the Louisiana Office of Workers' Compensation ("OWC") and the pertinent state agencies.
From a historical prospective, in 2009, the Louisiana Legislature completely revised workers' compensation laws by establishing guidelines for medical care and the adjudication of denials of medical treatment. As part of this revision, the Director of the OWC was instructed to promulgate rules to establish a Medical Treatment Schedule. In 2011, the MTG were promulgated and became effective.
In response to the MTG, claimants in the Barber case filed suit, seeking declaratory and injunctive relief challenging the constitutionality of certain provisions of the MTG process. In 2015, the 19th Judicial District Court ("JDC") judge found these provisions unconstitutional and issued a preliminary injunction enjoining the OWC from applying and/or enforcing those provisions. However, on appeal, the Louisiana First Circuit Appellate Court found that the issuance of a preliminary injunction under these circumstances was procedurally inappropriate and remanded the case back to the 19th JDC for a full trial on the merits.
A trial was held on February 7, 2017, and the 19th JDC judge issued a judgement enjoining the OWC from enforcing the MTG, in general, as well as certain statutory provisions of the MTG, including the appeal process to the Louisiana Medical Director. The judgment was signed on March 2, 2017. In response to this ruling, the OWC filed for a suspensive appeal. On March 9, 2017, the 19th JDC granted the OWC's motion for a suspensive appeal, thereby suspending the effect of the trial court's judgment, pending review by the Louisiana Supreme Court.
Although the claimants sought to have the MTG process declared unconstitutional in addition to seeking injunctive relief, there is no specific language in the March 2, 2017 judgment addressing the constitutionality of the MTG and appeal process. The judgment simply states that the Court granted the permanent injunction without specific reasons for such. A request for written reasons was filed on March 7, 2017, which should clarify the court's basis for the ruling.
Under Louisiana law, the Louisiana Supreme Court has original appellate jurisdiction when a law has been declared unconstitutional. However, it is not clear that the 19th JDC declared the MTG provisions unconstitutional, and thus, it is unclear whether the Louisiana Supreme Court will exercise original jurisdiction at this point.
The question now is, "What do we do with MTG and medical claim issues with our Louisiana claims regarding 1010 Forms, Medical Utilization Reviews, and the 1009 Appeals to the Louisiana Medical Director and appeals to the OWC Courts?" The simple answer at this point is, do the same thing we were already doing! With the signed suspensive appeal order in place, suspending the effect of the trial court's ruling, the MTG and all procedures, as they currently exist, are still to be followed pending a final ruling from the Louisiana Supreme Court. Moreover, the OWC has recently issued a notice that, "pending further action of the Appellate Court", the 1009 review process will continue to operate as usual.
We are keeping in touch with the OWC for the most current developments and court rulings, and we will keep you updated on the ultimate resolution of this significant ruling. Should you have any questions in the meantime, please feel free to contact us.