Louisiana Senate passes bill banning gender-affirming care

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A controversial bill — that at one point had been presumed dead — banning gender-affirming medical care for transgender youths in Louisiana was passed by the Senate on Monday and is likely to reach the governor’s desk in the coming days.

The bill, which passed in the Senate mainly along party lines, 29-10, would prohibit hormone treatments, gender-affirming surgery and puberty-blocking drugs for transgender minors in Louisiana. The measure will go back to the House, which has already overwhelmingly passed the legislation, to approve of minor amendments, including pushing back the effective date of the law to Jan. 1, 2024.

If the House concurs, the legislation would be sent to the desk of Gov. John Bel Edwards, a Democrat who opposes it. Edwards has not said whether he would veto the bill. If he does, lawmakers could convene a veto session to try to override his decision. Last session, Edwards chose not to block a law banning transgender athletes from participating in women and girls sports competitions in Louisiana, although he successfully vetoed a similar measure the year before.

The proposed gender-affirming care ban gained national attention last month when a Senate committee voted to kill the bill. Longtime Republican state Sen. Fred Mills was the tiebreaker vote, opposing the legislation citing that he “relied on science and data and not political or societal pressures.”

In a year when restrictions and prohibitions on gender-affirming care for transgender youths has been a priority on conservative agendas — with at least 18 states enacting laws limiting or banning the medical care, including all three of Louisiana’s bordering states — the rejection of the controversial legislation did not go unnoticed.

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Workers’ Compensation Subrogation of Administrative Fees and Costs

When a worker covered by workers’ compensation makes a claim against a third party, the workers’ compensation insurance retains the right to subrogate against any recovery from that third party for all benefits paid to or on behalf of a claimant injured at work. When subrogating for more than basic medical and indemnity benefits, the Texas workers’ compensation subrogation statute provides that “the net amount recovered by a claimant in a third‑party action shall be used to reimburse the carrier for benefits, including medical benefits that have been paid for the compensable injury.” TX Labor Code § 417.002.

In fact, all 50 states provide for similar subrogation. However, none of them precisely outlines which payments or costs paid by a compensation carrier constitute “compensation” and can be recovered. The result is industry-wide confusion and an ongoing debate and argument with claimants’ attorneys over what can and can’t be included in a carrier’s lien for recovery purposes.

In addition to medical expenses, death benefits, funeral costs and/or indemnity benefits for lost wages and loss of earning capacity resulting from a compensable injury, workers’ compensation insurance carriers also expend considerable dollars for case management costs, medical bill audit fees, rehabilitation benefits, nurse case worker fees, and other similar fees. They also incur other expenses in conjunction with the handling and adjusting of workers’ compensation claims. Workers’ compensation carriers typically assert, of course, that, they are entitled to reimbursement for such expenditures when it recovers its workers’ compensation lien. Injured workers and their attorneys disagree.

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