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Citing Burgess v. Sewerage & Water Board of New Orleans, 16-2267 (La. 6/29/17), 225 So.3d 1020, a Louisiana appellate court held an third-party-administrator ("TPA") was not liable for $48,000 in unpaid pharmacy charges incurred for treatment of an employee's injuries where the TPA had earlier advised both the dispensing pharmacy and the employee that it had issued the employee a prescription card that could be used at many pharmacies near the employee's location, and advising both further that it would not continue to pay charges through the Injured Workers' Pharmacy. The Office of Workers' Compensation found that the employer/TPA were liable for the unpaid bills, but the appellate court disagreed. The Louisiana Supreme Court's decision in Burgess was sufficiently broad to encompass the dispute in the instant case, held the court.
Thomas A. Robinson, J.D., the Feature National Columnist for the LexisNexis Workers’ Compensation eNewsletter, is co-author of Larson’s Workers’ Compensation Law (LexisNexis).
LexisNexis Online Subscribers: Citations below link to Lexis Advance.
See Corona v. Louisiana Corr. Inst. for Women, 2020-0260 (La.App. 1 Cir. 11/06/2020, 2020 La. App. LEXIS 1586
See generally Larson’s Workers’ Compensation Law, § 94..02.
Source: Larson’s Workers’ Compensation Law, the nation’s leading authority on workers’ compensation law
For a more detailed discussion of the case, see
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