LAC 37:III.1903. Definitions

Administrative Hearinghearing held in response to a request or complaint by a patient in need of future medical care or his/her representative, that the fund has failed or refused to pay for medical care or related benefits. The hearing shall be conducted before at least three board members. Future Medical Care and Related Benefits―all reasonable medical, surgical, hospitalization, physical rehabilitation, and custodial services, and includes drugs, prosthetic devices, and other similar materials reasonably necessary in the provision of such services. The fund's obligation to provide these benefits or to reimburse the claimant for those benefits is limited to the lesser of the amount billed therefor or the maximum amount allowed under the reimbursement schedule. Reimbursement Schedule―the most recent reimbursement schedules promulgated by the Department of Labor, Office of Workers' Compensation pursuant to R.S. 23:1034.2.