Current through Register Vol. 50, No. 9, September 20, 2024
A. A patient, who is deemed to be in need of
future medical care and related benefits pursuant to a final judgment issued by
a court of competent jurisdiction or as agreed to in a settlement reached
between the patient and the fund, may make a claim to the fund through the
board for future medical care and related benefits as incurred by the patient
and made necessary by the health care provider's malpractice.
B. If a patient's claim for future medical
care and related benefits is disputed or payment of the amount thereof has been
denied by the board, then the matter may be referred to the board for an
administrative hearing.
C.
1. The following administrative hearing
process shall be followed when such is requested by the claimant or the
claimant's representative. The claimant desiring to institute a hearing shall
prepare and file with the board a complaint setting forth:
a. the name and address of each
respondent;
b. a statement, in
ordinary and concise language, of the facts upon which the complaint is based,
together with supporting evidentiary material, including but not limited to,
whenever applicable, particular reference to the statute or statutes, or rules,
regulations, and orders that the claimant alleges have been violated.
2. Such complaint will be sent to
the general counsel for the board who will contact all parties to determine the
date of the hearing. The hearing panel will consist of at least three board
members. The parties may provide any evidence they deem necessary and may call
witnesses to give testimony that bears upon the issues. A court reporter will
be present to record the hearing and to administer the necessary oaths to any
witnesses. Each party will be allowed to make a brief opening statement,
present evidence and cross-exam any witnesses. The panel members will be
allowed to ask questions of both parties and any witnesses. All parties will be
allowed to make a closing statement. Following the closing statements, the
panel members will meet in private to reach a decision. Findings of fact and
decision of the panel will be put in written form and presented to the board in
executive session for a final determination and vote. The final decision will
be forwarded to the claimant or their representative and the fund's
counsel.
3. Should the claimant or
their representative disagree with the decision reached through the
administrative hearing process, they may file a petition in the 19th judicial
district court in accordance with
§1931 of these rules.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
40:1299.44(D)(3).
