As enacted, SB 408 leaves ASCs guessing about what to expect for their workers’ compensation reimbursements moving forward. The bill still creates the All Workers’ Compensation Medical Bill Database, but reimbursements are no longer pegged to the 75th percentile of submitted claims. Instead, the assistant secretary of the Office of Workers’ Compensation Administration must develop the new fee schedule for inpatient and outpatient hospital and ASC services by:

• Analyzing allowed amounts and paid amounts reflected in the database.
• Evaluating reimbursement percentiles for comparable services across geographic regions.
• Considering access to care metrics, including provider participation rates and treatment timeliness.
• Reviewing utilization patterns and cost drivers by procedure category.

The assistant secretary is required to begin the formal rulemaking process to adopt a medical fee schedule no later than July 1, 2029, with ASCs reimbursed according to current law until a new fee schedule is adopted.

Background

Louisiana ASCs participating in the state’s workers’ compensation program are currently reimbursed under Louisiana statute RS §23:1034.2(C)(1), enacted in 1987, and Louisiana Administrative Code Title 40, Chapter 25:2507(A), adopted in 1993. These rules require that participating ASCs be reimbursed at 90% of billed charges, though the Louisiana Ambulatory Surgery Center Association has explained that reimbursements are typically closer to 80% of covered charges.

Lawmakers attempted to reform the Workers’ Compensation Program in 2024 and 2025. During the 2024 legislative session, Rep. Michael Echols introduced three different measures — HB 198, HB 870 and HB 863 — intended to force the adoption of a medical fee reimbursement. HB 863 became the primary vehicle for Echol’s ideas and would have required adoption of a reimbursement schedule based on the reimbursement schedules of surrounding states. Ultimately, the measure died in the Senate Committee on Labor and Industrial Relations following extensive opposition from ASCA and the Louisiana Ambulatory Surgery Center Association.

In 2025, Rep. Echols returned with HB 117, a reintroduction of the provisions found in HB 863, but the primary focus was SB 213, introduced by Sen. Alan Seabaugh. That measure would have required facilities to be reimbursed at rates no higher than the average of the charges for at least 30 similar facilities in the state. Constitutional issues ultimately derailed the bill, and as a fallback, the Senate adopted SR 128, which created a Senate task force to provide recommendations to the legislature on reforming the workers’ compensation program.

At present

The work of the Senate task force resulted in the introduction of SB 408 in March 2026 by Sen. Brach Myers. Alongside provisions related to prior authorization and electronic billing, the bill required the creation of the All Workers’ Compensation Medical Bill Database, to which workers’ compensation carriers would have to submit medical and pharmacy claims information. The claims information would then be used to devise a new medical fee schedule, with reimbursement for inpatient and outpatient hospital and ASC services equal to the 75th percentile of paid amounts for the same or substantially similar services.

Reliance on future claims data to develop reimbursement rates meant stakeholders still lacked clear insight into how the legislation would impact them, which was the primary issue with past proposals. This drove concerns that reimbursement rates would ultimately be reduced, threatening access to care in the program. Feedback from lawmakers helped to somewhat assuage those concerns, with senators indicating that inpatient and outpatient hospital claims data would be aggregated with ASC claims data when determining the 75th percentile for reimbursement purposes. This suggested to many that ASC reimbursements could actually improve under the legislation; ultimately, both the Louisiana Ambulatory Surgery Center Association and the Louisiana Hospital Association supported the bill.

By the end of May, SB 408 was sitting in conference committee at the request of Myers, who said the chambers needed more time to resolve differences over a compliance safe harbor and provisions related to maximum medical improvement. In short order, the conference committee reported the bill out and both chambers adopted the conference committee report on May 29, teeing the bill up for transmission to the governor, who signed it into law on June 3.

Despite the disagreement between the chambers having nothing to do with the new reimbursement methodology in the bill, stakeholders soon learned the methodology had become a casualty of the conference committee. The belief that the new methodology could improve ASC reimbursements was its undoing. As reported by the Louisiana Ambulatory Surgery Center Association, workers’ compensation carriers and business groups in the state fiercely lobbied the legislature to remove the methodology and instead give the assistant secretary of the Office of Workers’ Compensation Administration a freer hand to determine reimbursements.

As a result, Louisiana ASCs will face more issues to resolve and more threats to defend against during rulemaking than they otherwise would have.

Write Stephen Abresch at sabresch@ascassociation.org with questions.