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La. Rev. Stat. § 23:1142 (2026)

Approval of health care providers; fees

✓ current as of May 2026
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§1142. Approval of health care providers; fees

           A. Definitions. For the purposes of this Section, the following terms shall have the following meanings unless the context clearly indicates otherwise:

           (1) "Payor" shall mean the entity responsible, whether by law or contract, for the payment of the medical expenses incurred by a claimant as a result of a work related injury.

           (2) "Utilization review company" shall mean the company or entity which contracts with the payor, and which entity reviews the claimant's medical records and information and makes the determination of medical necessity in accordance with this Chapter, for the purposes of assisting the payor with the authorization of the claimant's medical care, services and treatment requested pursuant to this Chapter.

           B. Nonemergency care. (1)(a) Except as provided herein, each health care provider may not incur more than a total of seven hundred fifty dollars in nonemergency diagnostic testing or treatment without the mutual consent of the payor and the employee as provided by regulation. Except as provided herein, that portion of the fees for nonemergency services of each health care provider in excess of seven hundred fifty dollars shall not be an enforceable obligation against the employee or the employer or the employer's workers' compensation insurer unless the employee and the payor have agreed upon the diagnostic testing or treatment by the health care provider.

           (b)(i) The payor may contract with a utilization review company to assist the payor in determining if the request for nonemergency diagnostic testing or treatment, in an amount which exceeds seven hundred fifty dollars, is a medical necessity as provided pursuant to this Chapter.

           (ii) A medical necessity determination by a utilization review company and the payor's consent to authorize the requested nonemergency diagnostic testing and treatment shall require only a review of the claimant's medical records and shall not require an examination of the employee.

           (2)(a) When the payor has agreed to the diagnostic testing or treatment, the health care provider shall not issue any demand for payment to the employee or his family until the payor denies liability for the diagnostic testing or treatment. Notwithstanding the foregoing, the health care provider may reasonably communicate with the employee or his attorney or representative for the purpose of pursuing its claim against the payor.

           (b) A health care provider who knowingly and willfully violates this Paragraph may be ordered by the workers' compensation judge to pay penalties not to exceed two hundred fifty dollars per violation plus reasonable attorney fees. The penalty shall not exceed one thousand dollars for any demand for payment to an employee or his family which is issued after the health care provider has been penalized for a previous demand for payment to that employee or his family.

           C. Emergency care. (1) In no event shall prior consent be required for any emergency procedure or treatment deemed immediately necessary by the treating health care provider. Any health care provider who authorizes or orders emergency diagnostic testing or treatment, when said diagnostic testing or treatment is held not to have been of an emergency nature, shall be responsible for all of the charges incurred in such diagnostic testing or treatment. Said health care provider shall bear the burden of proving the emergency nature of the diagnostic testing or treatment.

           (2) Fees for those services of the health care provider held not to have been of an emergency nature shall not be an enforceable obligation against the employee or the employer or the employer's workers' compensation insurer unless the employee and the payor have agreed upon the treatment or diagnostic testing by the health care provider, except as provided in R.S. 23:1272(D).

           D. Fees and expenses. If the payor has not consented to the request to incur more than a total of seven hundred fifty dollars for any and all nonemergency diagnostic testing or treatment when such consent is required by this Section, and it is determined by a court having jurisdiction in an action brought either by the employee or the health care provider that the withholding of such consent was arbitrary and capricious, or without probable cause, the employer or the insurer shall be liable to the employee or health care provider bringing the action for reasonable attorney fees related to this dispute and to the employee for any medical expenses so incurred by him for an aggravation of the employee's condition resulting from the withholding of such health care provider services.

           E. Exception. In the event that the payor has denied that the employee's injury is compensable under this Chapter, then no approval from the payor is required prior to the provision of any diagnostic testing or treatment for that injury.

           Acts 1988, No. 617, §1; Acts 1995, No. 1137, §1, eff. June 29, 1995; Acts 1997, No. 1472, §1; Acts 2012, No. 235, §1, eff. August 1, 2012.


Notes of Decisions
Cited in 142 cases (3 in the last 5 years), 1983–2026 · leading case: Darvel Burgess v. Sewerage & Water Bd. of New Orleans, 225 So. 3d 1020 (La. 2017).
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Darvel Burgess v. Sewerage & Water Bd. of New Orleans, 225 So. 3d 1020 (La. 2017). · cites it 42× “R.S. 23:1142. REVERSED AND REMANDED TO THE OFFICE OF WORKERS' COMPENSATION FOR FURTHER PROCEEDINGS CONSISTENT WITH THIS OPINION.”
Lafayette Bone & Jt. Clinic (Charles Morris) v. Louisiana United Bus. Sif, 194 So. 3d 1112 (La. 2016). · cites it 33× “Consequently, the provisions of LSA-R.S. 23:1142 became applicable to those five to seven 9 occasions on which prescriptions were dispensed without LUBA’s consent.”
Parfait v. Gulf Island Fabrication, Inc., 733 So. 2d 11 (La. Ct. App. 1999). · cites it 13× “At the time of Parfait's accident and injury, LSA-R.S. 23:1142 provided in pertinent part: [4] A.”
Rebel Distributors Corp. v. LUBA Workers' Comp., 137 So. 3d 91 (La. Ct. App. 2014). · cites it 11× “R.S. 23:1142. 3. The Trial Court erred in not granting penalties and attorney fees against LUBA for their failure to pay anything for the reasonable and necessary prescription medication received by Claimants.”
Carradine v. Regis Corp., 52 So. 3d 181 (La. Ct. App. 2010). · cites it 17× “R.S. 23:1142 “assumed” that an employer would normally have notice of the employee’s claim for benefits and be “in a position to deny/approve the claimed expenses.”
Schindler v. Orleans Reg'l Sec., 862 So. 2d 1032 (La. Ct. App. 2003). · cites it 12× “R.S. 23:1142 B. Following the trial, the workers' compensation judge concluded that Schindler was within the course and scope of his *1036 employment during the May 29, 1997 accident and injured his left eye and/or tear duct, but not his left shoulder.”
Downs v. Chateau Living Ctr., 167 So. 3d 875 (La. Ct. App. 2015). · cites it 12× “R.S. 23:1142. Id. On appeal, the Third Circuit affirmed the judgment of the WCJ.”
Authement v. Shappert Eng'g, 840 So. 2d 1181 (La. 2003). · cites it 3× “Additionally, the court examined the provisions of LSA-R.S. 23:1142 which provides *1185 for attorney fees if the employer arbitrarily and capriciously denies consent to incur more than $750 for any non-emergency diagnostic testing or treatment and found that the statute does…”
Stewart v. Livingston Par. Sch. Bd., 991 So. 2d 469 (La. Ct. App. 2008). · cites it 6× “*474 Statutory Limitation on Medical Expenses The School Board argues in its first assignment of error that the OWC judge erred in failing to apply the statutory cap on medical expenses in accordance with LSA-R.S. 23:1142 B. Initially, we are compelled to point out that the…”
Louviere v. Food & Fun, Inc., 941 So. 2d 155 (La. Ct. App. 2006). · cites it 10× “R.S. 23:1142. Accordingly, a judgment granting the motion for summary judgment filed by Defendant, Food & Fun, Inc.”
Daniel v. Point to Point Directional Drilling, Inc., 139 So. 3d 613 (La. Ct. App. 2014). · cites it 13× “R.S. 23:1142 and ordered it to reimburse Blue Cross/Blue Shield in full for any medical benefits it paid pursuant to La.”
Bordelon v. Lafayette Consol. Gov't, 149 So. 3d 421 (La. Ct. App. 2014). · cites it 6× “R.S 23:1142 and denied Dr. Bordelon penalties and attorney fees.”
Show all 142 citing cases →
La. Rev. Stat. § 23:1142(A): 3 cases
Evergreen Presbyterian Minist. v. Wallace, 968 So. 2d 256 (La. Ct. App. 2007).
Poole v. Guy Hopkins Constr. Co., 177 So. 3d 142 (La. Ct. App. 2015).
Tyler v. Rockwood Ins. Co., 690 So. 2d 834 (La. Ct. App. 1997).
La. Rev. Stat. § 23:1142(A)(1): 10 cases
Rebel Distributors Corp. v. LUBA Workers' Comp., 137 So. 3d 91 (La. Ct. App. 2014). “R.S. 23:1142. 3. The Trial Court erred in not granting penalties and attorney fees against LUBA for their failure to pay anything for the reasonable and necessary prescription medication received by Claimants.”
Downs v. Chateau Living Ctr., 167 So. 3d 875 (La. Ct. App. 2015). “R.S. 23:1142. Id. On appeal, the Third Circuit affirmed the judgment of the WCJ.”
Johnson v. Sewerage & Water Bd. New Orleans, 190 So. 3d 785 (La. Ct. App. 2016).
Henderson v. New Medico Assocs., Inc., 667 So. 2d 1094 (La. Ct. App. 1995).
INA v. Hayes, 643 So. 2d 190 (La. Ct. App. 1994).
La. Rev. Stat. § 23:1142(B): 44 cases
Darvel Burgess v. Sewerage & Water Bd. of New Orleans, 225 So. 3d 1020 (La. 2017). “R.S. 23:1142. REVERSED AND REMANDED TO THE OFFICE OF WORKERS' COMPENSATION FOR FURTHER PROCEEDINGS CONSISTENT WITH THIS OPINION.”
Lafayette Bone & Jt. Clinic (Charles Morris) v. Louisiana United Bus. Sif, 194 So. 3d 1112 (La. 2016). “Consequently, the provisions of LSA-R.S. 23:1142 became applicable to those five to seven 9 occasions on which prescriptions were dispensed without LUBA’s consent.”
Parfait v. Gulf Island Fabrication, Inc., 733 So. 2d 11 (La. Ct. App. 1999). “At the time of Parfait's accident and injury, LSA-R.S. 23:1142 provided in pertinent part: [4] A.”
Prejean v. RPM PIZZA, 631 So. 2d 1359 (La. Ct. App. 1994).
Daniel v. Point to Point Directional Drilling, Inc., 139 So. 3d 613 (La. Ct. App. 2014). “R.S. 23:1142 and ordered it to reimburse Blue Cross/Blue Shield in full for any medical benefits it paid pursuant to La.”
La. Rev. Stat. § 23:1142(B)(1): 15 cases
Authement v. Shappert Eng'g, 840 So. 2d 1181 (La. 2003). “Additionally, the court examined the provisions of LSA-R.S. 23:1142 which provides *1185 for attorney fees if the employer arbitrarily and capriciously denies consent to incur more than $750 for any non-emergency diagnostic testing or treatment and found that the statute does…”
Rebel Distributors Corp. v. Luba Workers' Comp., 144 So. 3d 825 (La. 2013).
Rebel Distributors Corp. v. LUBA Workers' Comp., 137 So. 3d 91 (La. Ct. App. 2014). “R.S. 23:1142. 3. The Trial Court erred in not granting penalties and attorney fees against LUBA for their failure to pay anything for the reasonable and necessary prescription medication received by Claimants.”
Bordelon v. Lafayette Consol. Gov't, 149 So. 3d 421 (La. Ct. App. 2014). “R.S 23:1142 and denied Dr. Bordelon penalties and attorney fees.”
Rivera v. M & R Cable Contractors, Inc., 896 So. 2d 90 (La. Ct. App. 2004).
La. Rev. Stat. § 23:1142(B)(1)(a): 2 cases
Rebel Distributors Corp. v. Luba Workers' Comp., 144 So. 3d 825 (La. 2013).
Elizabeth Soileau v. Wal-Mart Stores, Inc. (La. 2019).
La. Rev. Stat. § 23:1142(B)(b): 1 case
Mulvihill v. Jefferson Par. Hosp. Serv. Dist. No. 2, 116 So. 3d 672 (La. Ct. App. 2013).
La. Rev. Stat. § 23:1142(B)(l)(a): 3 cases
Downs v. Chateau Living Ctr., 167 So. 3d 875 (La. Ct. App. 2015). “R.S. 23:1142. Id. On appeal, the Third Circuit affirmed the judgment of the WCJ.”
Arrant v. Wayne Acree PLS, Inc., 164 So. 3d 321 (La. Ct. App. 2015).
Cross v. Slayter Trucking Companies, 206 So. 3d 1124 (La. Ct. App. 2016).
La. Rev. Stat. § 23:1142(B)(l)(b)(i): 1 case
Bourque v. Transit Mix/Trinity Ind., 162 So. 3d 690 (La. Ct. App. 2015).
La. Rev. Stat. § 23:1142(C): 6 cases
Parfait v. Gulf Island Fabrication, Inc., 733 So. 2d 11 (La. Ct. App. 1999). “At the time of Parfait's accident and injury, LSA-R.S. 23:1142 provided in pertinent part: [4] A.”
Louviere v. Food & Fun, Inc., 941 So. 2d 155 (La. Ct. App. 2006). “R.S. 23:1142. Accordingly, a judgment granting the motion for summary judgment filed by Defendant, Food & Fun, Inc.”
Daniel v. Point to Point Directional Drilling, Inc., 139 So. 3d 613 (La. Ct. App. 2014). “R.S. 23:1142 and ordered it to reimburse Blue Cross/Blue Shield in full for any medical benefits it paid pursuant to La.”
Henderson v. New Medico Assocs., Inc., 667 So. 2d 1094 (La. Ct. App. 1995).
Boudreaux v. Ideal Rentals, Inc., 844 So. 2d 919 (La. Ct. App. 2003).
La. Rev. Stat. § 23:1142(C)(1): 4 cases
Parfait v. Gulf Island Fabrication, Inc., 733 So. 2d 11 (La. Ct. App. 1999). “At the time of Parfait's accident and injury, LSA-R.S. 23:1142 provided in pertinent part: [4] A.”
Rivera v. M & R Cable Contractors, Inc., 896 So. 2d 90 (La. Ct. App. 2004).
Elizabeth Soileau v. Wal-Mart Stores, Inc. (La. 2019).
Patricia Matthews v. Big Easy Janitorial, L.L.C., & Louisiana Constr. & Indus. Self Insurers Fund, 346 So. 3d 325 (La. Ct. App. 2022).
La. Rev. Stat. § 23:1142(D): 12 cases
Lafayette Bone & Jt. Clinic (Charles Morris) v. Louisiana United Bus. Sif, 194 So. 3d 1112 (La. 2016). “Consequently, the provisions of LSA-R.S. 23:1142 became applicable to those five to seven 9 occasions on which prescriptions were dispensed without LUBA’s consent.”
Ferrier v. Jordache-Ditto's, 662 So. 2d 14 (La. Ct. App. 1995).
George v. Guillory, 776 So. 2d 1200 (La. Ct. App. 2000).
Barron v. First Lake Props., Inc., 636 So. 2d 970 (La. Ct. App. 1994).
Curtis v. Wet Solutions, Inc., 722 So. 2d 421 (La. Ct. App. 1998).
La. Rev. Stat. § 23:1142(E): 32 cases
Carradine v. Regis Corp., 52 So. 3d 181 (La. Ct. App. 2010). “R.S. 23:1142 “assumed” that an employer would normally have notice of the employee’s claim for benefits and be “in a position to deny/approve the claimed expenses.”
Parfait v. Gulf Island Fabrication, Inc., 733 So. 2d 11 (La. Ct. App. 1999). “At the time of Parfait's accident and injury, LSA-R.S. 23:1142 provided in pertinent part: [4] A.”
Louviere v. Food & Fun, Inc., 941 So. 2d 155 (La. Ct. App. 2006). “R.S. 23:1142. Accordingly, a judgment granting the motion for summary judgment filed by Defendant, Food & Fun, Inc.”
Connor v. Fam. Dollar Store, 36 So. 3d 339 (La. Ct. App. 2010).
Daniel v. Point to Point Directional Drilling, Inc., 139 So. 3d 613 (La. Ct. App. 2014). “R.S. 23:1142 and ordered it to reimburse Blue Cross/Blue Shield in full for any medical benefits it paid pursuant to La.”
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