WCA-0012-0909 Nonprecedential Affirmed Processed

Rebel Distributors Corp., Inc. (Mary Doucet) v. Luba Worker's Comp.

Louisiana Court of Appeal, Third Circuit · Filed April 2, 2014

Also decided on this docket: La. Ct. App. 3d Cir., March 6, 2013

The holding in the court’s own words

We conclude that the WCJ’s denial of Physician Partner’s motion for new trial was rendered before the consideration of any of the other pending issues.

Quoted verbatim from the opinion — no paraphrase, nothing generated. Not yet human-reviewed. How we find the holding.

Authorities cited

Identified automatically; this list may not be exhaustive.

Opinion text

STATE OF LOUISIANA
COURT OF APPEAL, THIRD CIRCUIT

12-909 consolidated with 12-910, 12-911, 12-912, 12-913, 12-914, 12-915,
12-916, 12-917, 12-918, 12-919, 12-920, 12-921, 12-922, 12-923, 12-924,
12-925, 12-926, and 12-927

REBEL DISTRIBUTORS CORP., INC. d/b/a PHYSICIAN PARTNER AND
PHARMACY PARTNER (MARY DOUCET)

VERSUS

LUBA WORKERS’ COMP., ET AL.

**********

APPEAL FROM THE
OFFICE OF WORKERS’ COMPENSATION – DISTRICT 04
PARISH OF LAFAYETTE, NO. 09-00160
SHARON MORROW, WORKERS’ COMPENSATION JUDGE

**********

JIMMIE C. PETERS
JUDGE

**********

Court composed of Ulysses Gene Thibodeaux, Chief Judge, Jimmie C. Peters, and
Marc T. Amy, Judges.

AFFIRMED.

THIBODEAUX, Chief Judge, dissents in part and assigns written reasons,
with the exceptions of No. 12-923 and No. 12-924.

Harry K. Burdette
The Glenn Armentor Law Corporation
300 Stewart Street
Lafayette, LA 70501
(337) 233-1471
COUNSEL FOR PLAINTIFF/APPELLANT:
Rebel Distributors Corporation, Inc. d/b/a

Physician Partner and Pharmacy Partner
W. Michael Adams
Stacey D. Williams
Blanchard, Walker, O’Quinn & Roberts
P. O. Drawer 1126
Shreveport, LA 71163-1126
(318) 221-6858
COUNSEL FOR PLAINTIFF/APPELLANT:
Rebel Distributors Corporation, Inc. d/b/a
Physician Partner and Pharmacy Partner

Jeffrey C. Napolitano
Juge, Napolitano, Guilbeau, Ruli & Frieman
3320 West Esplanade Avenue North
Metairie, LA 70002
(504) 831-7270
COUNSEL FOR DEFENDANTS/APPELLEES:
LUBA Casualty Insurance Company
Acadiana Plastics Manufacturing, Inc.

PETERS, J.

We consider this matter on remand from the supreme court following its

decision in Rebel Distributors Corp., Inc. v. LUBA Workers’ Compensation, 13-

749 (La. 10/15/13), __ So.3d __. In its remand to this court, the supreme court

ordered that we consider the remaining issues raised by the parties which were not

resolved by its decision. After complying with the supreme court order on remand,

we affirm the judgment of the workers’ compensation judge in all respects.

DISCUSSION OF THE RECORD

The facts of this matter were fully addressed in both our prior opinion, Rebel

Distributors Corp., Inc. v. LUBA Workers’ Compensation, 12-909 (La.App. 3 Cir.

3/6/13), 129 So.3d 80, and the supreme court’s opinion, and we adopt those facts

as though fully incorporated herein. In our decision, we held that the June 29,

2007 act of assignment between Rebel Distributors/Physician Partner and Dr.

Heard/Clinic violated the anti-assignment language of La.R.S. 23:1205(A) and that

the November 16, 2010 agreement between Rebel Distributors/Physician Partner

and Dr. Heard/Clinic to convert the original assignment agreement into a

retroactive agency agreement did not qualify as an express novation sufficient to

accomplish the intended result. We reached this disposition based on our

conclusion that novation could not have taken place because a substantial part of

the original performance was still owed and because the attempted novation merely

modified the terms of the June 29, 2007 agreement rather than extinguishing it.

La.Civ.Code art. 1881. Furthermore, because the workers’ compensation judge

(WCJ) had already declared the June 29, 2007 agreement null and void, we found

that La.Civ.Code art. 1883 would prohibit a novation from having any effect where

the underlying obligation to be extinguished either does not exist or is absolutely

null. Thus, we found that Rebel Distributors/Physician Partner had no right of

action such that it could institute this suit. La.Code Civ.P. art. 927(A)(6).

Following our decision, Rebel Distributors/Physician Partner sought and

was granted writs by the supreme court. Rebel Distribs. Corp., Inc. v. LUBA

Workers’ Comp., 13-749 (La. 6/14/13), 118 So.3d 1092. In reversing our decision,

the supreme court held that “the anti-assignment language of La. R.S. 23:1205(A)

does not prohibit the assignment of a health care provider’s claims to a third party,

the express contractual novation was effective, and an agent can statutorily be

considered a health care provider based on the definition contained in La. R.S.

23:1021(6).” Rebel Distribs., __ So.3d at __.

OPINION

Motion to Strike filed by Rebel Distributors/Physician Partner

Originally, Rebel Distributors/Physician Partner raised three assignments of

error on appeal, and LUBA raised eight in its appellee brief. Rebel

Distributors/Physician Partner has filed a motion to strike a number of the

assignments of error raised by LUBA, and we will address that motion first.

Rebel Distributors/Physician Partner asserts in its motion to strike that the

fifth, seventh, and eighth assignments asserted by LUBA were not addressed in its

answer to the appeal and should be stricken; and that LUBA’s first, fourth, and

sixth assignments of error as well as its complaints in paragraphs three, four, and

five of its answer to the appeal have been decided unfavorably for LUBA by the

supreme court’s decision and should be stricken as well. In making this argument,

Rebel Distributors/Physician Partner relies on La.Code Civ.P. art. 2133(A), which

provides:

An appellee shall not be obliged to answer the appeal unless he
desires to have the judgment modified, revised, or reversed in part or
2

unless he demands damages against the appellant. In such cases, he
must file an answer to the appeal, stating the relief demanded, not
later than fifteen days after the return day or the lodging of the record
whichever is later. The answer filed by the appellee shall be
equivalent to an appeal on his part from any portion of the judgment
rendered against him in favor of the appellant and of which he
complains in his answer. Additionally, however, an appellee may by
answer to the appeal, demand modification, revision, or reversal of the
judgment insofar as it did not allow or consider relief prayed for by an
incidental action filed in the trial court. If an appellee files such an
answer, all other parties to the incidental demand may file similar
answers within fifteen days of the appellee’s action.

The fifth, seventh, and eighth assignments of error asserted by LUBA are as

follows:

5. The Trial Court erred in failing to recognize that
employer/insurer is entitled to choose the pharmacy to dispense
pharmaceuticals.

....

7. The Trial Court erred in failing to find that the contractual
relationship between Rebel and Dr. Heard creates an illegal
kickback scheme in violation of 37:1745.

8. The Trial Court erred in failing to find that the procedure which
permits each individual packager to arbitrarily set its own AWP
without regard to its cost or wholesale price is in violation of
23:1034.2.

In its Answer to Appeal, LUBA alleged the following representations:

1.

Defendant contends that the trial court erred in permitting a new
trial after denying the Motion for a New Trial.

2.

Defendant contends that the trial court erred in denying
defendant’s Exception of Res Judicata.

3.

Defendant contends that the trial court erred in finding that
Physician Partner had a cause of action against LUBA for worker’s
[sic] compensation benefits.

3

4.

Defendant contends that the trial court erred in finding that
Physician Partner was an agent of Dr. Michael Heard.

5.

Defendant contends that the trial court erred in finding that
contract entered into Post-Judgment was effective for transactions
occurring prior to judgment.

6.

In all other respects the judgment of the trial court should be
affirmed without change.

In Carradine v. Regis Corp., 10-529, p. 11 (La.App. 3 Cir. 11/3/10), 52

So.3d 181, 190, we stated that La.Code Civ.P. art. 2133(A) has been interpreted,

jurisprudentially, to mean “that an answer to an appeal only operates as an appeal

from those aspects of the judgment about which the answer complains.”

Comparing LUBA’s answer to the language of the three assignments of error at

issue, we agree with Rebel Distributors/Physician Partner’s argument that LUBA’s

answer to the appeal fails to address the issues raised in its fifth, seventh, and

eighth assignments of error. Thus, we grant the motion to strike these assignments

of error.

With regard to the second half of the motion to strike, the first, fourth, and

sixth assignments of error asserted by LUBA are as follows:

1. The Trial Court erred in admitting a second contract executed
the day before the hearing on Motion for New Trial which
purports to negate the original contract in evidence and in effect
at the time of the original hearing in July 2010.

....

4. The Trial Court erred in finding that Rebel was a healthcare
provider under Section 1021 (6).

....

4

6. The Trial Court erred in failing to find that the contractual
relationship between Rebel and Dr. Heard is an illegal
assignment in violation of 23:1205.

The third, fourth, and fifth paragraphs of the answer to the appeal address whether

Rebel Distributors/Physician Partner has a cause of action against LUBA, the

agency issue, and the retroactive nature of the novation. All of these were

addressed in Rebel Distributors/Physician Partner’s favor by the supreme court,

and we grant the motion to strike these arguments.

Remaining Matters to be Considered

Rebel Distributors/Physician Partner has its three assignments of error left

for consideration on remand:

1. The Trial Court erred in not granting injured workers in
compensable Workers’ Compensation claims their right to
choice of pharmacy.

2. The Trial Court erred in limiting payment of the outstanding
pharmacy bill’s [sic] to $750.00 per Claimant under La.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.

LUBA’s remaining issues on remand include the first two paragraphs of its answer

to the appeal and its second and third assignments of error.

Rebel Distributors/Physician Partner’s First Assignment of Error

In this assignment of error, Rebel Distributors/Physician Partner argues that

the WCJ erred in not granting Ms. Doucet her choice of pharmacy. However,

pursuant to La.Code Civ.P. art. 927(B), we notice on our own motion that Rebel

Distributors/Physician Partner’s pleadings fail to state a right of action in regard to

this issue. The only parties having a right of action to raise this issue are the

employee, Ms. Doucet, and, possibly, the employer/insurer. However, based on
5

our grant of the motion to strike LUBA’s fifth assignment of error, which also

raised this issue, the only party with a right to question her choice of pharmacy is

Ms. Doucet, who is not a party to this claim. Accordingly, we find no merit in this

assignment.

Rebel Distributors/Physician Partner’s Second Assignment of Error

In this assignment of error, Rebel Distributors/Physician Partner argues that

the WCJ erred in limiting the payment of the outstanding pharmacy bill to $750.00

through an erroneous application of La.R.S. 23:1142. Rebel Distributors/Physician

Partner argues that the WCJ should have applied La.R.S. 23:1203 instead to award

the lesser of the actual cost or the cost allowed under the reimbursement schedule

for the prescribed medication at issue. We find no merit in this argument.

Louisiana Revised Statutes Article 23:1142 is located in Subpart G, entitled

“ATTORNEYS AND PHYSICIANS[,]” of Part I, “SCOPE AND

OPERATION[,]” of the Workers’ Compensation Act. At the time of the

transaction at issue in this litigation, La.R.S. 23:1142 read, in pertinent part:

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.

B. Nonemergency care. (1) 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.

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(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.

Louisiana Revised Statutes Article 23:1203 is located in Subpart A, entitled

“General Provisions[,]” of Part II, “Benefits[.]” At the time of this transaction, it

provided:

A. In every case coming under this Chapter, the employer shall
furnish all necessary drugs, supplies, hospital care and services,
medical and surgical treatment, and any nonmedical treatment
recognized by the laws of this state as legal, and shall utilize such
state, federal, public, or private facilities as will provide the injured
employee with such necessary services. Medical care, services, and
treatment may be provided by out-of-state providers or at out-of-state
facilities when such care, services, and treatment are not reasonably
available within the state or when it can be provided for comparable
costs.

B. The obligation of the employer to furnish such care, services,
treatment, drugs, and supplies, whether in state or out of state, is
limited to the reimbursement determined to be the mean of the usual
and customary charges for such care, services, treatment, drugs, and
supplies, as determined under the reimbursement schedule annually
published pursuant to R.S. 23:1034.2 or the actual charge made for the
service, whichever is less. Any out-of-state provider is also to be
subject to the procedures established under the office of workers’
compensation administration utilization review rules.

C. The employer shall furnish to the employee the necessary
cost of repair to or the replacement of any prosthetic device damaged
or destroyed by accident in the course and scope and arising out of
such employment, including but not limited to damage or destruction
of eyeglasses, artificial limbs, hearing aids, dentures, or any such
prosthetic devices whatsoever.
7

D. In addition, the employer shall be liable for the actual
expenses reasonably and necessarily incurred by the employee for
mileage reasonably and necessarily traveled by the employee in order
to obtain the medical services, medicines, and prosthetic devices,
which the employer is required to furnish under this Section, and for
the vocational rehabilitation-related mileage traveled by the employee
at the direction of the employer. When the employee uses his own
vehicle, he shall be reimbursed at the same rate per mile as established
by the state of Louisiana for reimbursement of state employees for use
of their personal vehicle on state business. The office shall inform the
employee of his right to reimbursement for mileage.

E. Upon the first payment for a claimant’s medical care, service,
or treatment, the payor, as defined in R.S. 23:1142(A)(1), shall
communicate to the claimant information, in plain language, regarding
the procedure for requesting an independent medical examination in
the event a dispute arises as to the condition of the employee. A
payor shall not deny medical care, service, or treatment to a claimant
unless the payor can document a reasonable and diligent effort in
communicating such information. A payor who denies medical care,
service, or treatment without making such an effort may be fined an
amount not to exceed five hundred dollars or the cost of the medical
care, service, or treatment, whichever is more.

Although La.R.S. 23:1142(B)(1) does not specifically include prescription

medication in the “nonemergency diagnostic testing or treatment” which is subject

to the $750.00 cap, we find no error in the WCJ’s application of La.R.S. 23:1142

to Rebel Distributors/Physician Partner’s claim against LUBA. Based on its

placement within the section pertaining to the provision of “Benefits” and the fact

that it specifically addresses the duty or obligation of the employer to furnish the

employee all necessary medical, surgical, and non-medical treatment, we find that

the terms of La.R.S. 23:1203 are applicable to claims by the employee against the

employer/insurer. Moreover, based on La.R.S. 23:1142’s placement in that section

pertaining to attorneys and what should more properly be entitled “Health Care

Providers,” we find that this statute applies to claims by health care

providers/agents against the employer/insurer, who, as defined as the “payor[,]” is

the “entity responsible, whether by law or contract, for the payment of the medical

8

expenses incurred by the claimant as a result of a work related injury.” La.R.S.

23:1142(A)(1). Based on this determination, we find no merit in Rebel

Distributors/Physician Partner’s arguments concerning the WCJ’s application of

La.R.S. 23:1142 to its claims against LUBA.

Rebel Distributors/Physician Partner’s Third Assignment of Error

Finally, Rebel Distributors/Physician Partner argue that the WCJ erred in not

awarding it penalties and attorney fees based on LUBA’s failure to pay the

amounts charged for Ms. Doucet’s medications.

Rebel Distributors/Physician Partner’s argument on this issue is limited to

three sentences: “LUBA has paid nothing for medications which were reasonable

and necessary to its compensable Workers’ Compensation Claimants. This is

contrary to law. LUBA did not even offer to pay what they thought may be a

lesser amount they could pay through their pharmacy benefit manager. They

simply paid nothing!”

LUBA’s argument, on the other hand, is based on its claim that the

employer/insurer has the right to designate the pharmacy through which its

workers’ compensation claimants receive the medications necessary for treating

their work-related injuries. It further argues that its actions in denying payment of

Rebel Distributors/Physician Partner’s claims were neither unreasonable nor

arbitrary and capricious as the claims presented novel legal issues and it provided

reasonable notice to Rebel Distributors/Physician Partner and Dr. Heard/Clinic that

it would no longer authorize or pay for the medications dispensed by Dr.

Heard/Clinic, which notice was ignored by Dr. Heard/Clinic.

9

The WCJ’s reasons for denying Rebel Distributors/Physician Partner’s

claims for penalties and attorney fees were three-fold. In her oral reasons for

judgment, she stated:

I find that the employer and insurer in these matters had reasonable
legal justification under various grounds. One, whether the plaintiff
met the definition of healthcare provider. Two, the fact that the
insurer had notified the plaintiff that it would not pay, and plaintiff
continued to dispense. And that’s the reason I went with the Seven
Hundred and Fifty Dollar cap. I don’t know that as a practical matter,
if it makes any difference; but I do note that the plaintiff, Dr. Heard,
continued to dispense after they were informed there would not be any
payment forthcoming. And three, because of the issue of whether the
employer’s right to choose a pharmacy is an unfettered one.

Without addressing LUBA’s right to choose the dispensing pharmacy, as

that issue is not before us, we find no error in the WCJ’s denial of penalties and

attorney fees. With regard to penalties and attorney fees, La.R.S. 23:1142 provides

in part:

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
heath 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.

Also, at the time of these transactions, La.R.S. 23:1201 (emphasis added) provided

with regards to penalties and attorney fees:

E. Medical benefits payable under this Chapter shall be paid
within sixty days after the employer or insurer receives written notice
thereof.
10

F. Except as otherwise provided in this Chapter, failure to
provide payment in accordance with this Section or failure to consent
to the employee’s request to select a treating physician or change
physicians when such consent is required by R.S. 23:1121 shall result
in the assessment of a penalty in an amount up to the greater of twelve
percent of any unpaid compensation or medical benefits, or fifty
dollars per calendar day for each day in which any and all
compensation or medical benefits remain unpaid or such consent is
withheld, together with reasonable attorney fees for each disputed
claim; however, the fifty dollars per calendar day penalty shall not
exceed a maximum of two thousand dollars in the aggregate for any
claim. The maximum amount of penalties which may be imposed at a
hearing on the merits regardless of the number of penalties which
might be imposed under this Section is eight thousand dollars. An
award of penalties and attorney fees at any hearing on the merits shall
be res judicata as to any and all claims for which penalties may be
imposed under this Section which precedes the date of the hearing.
Penalties shall be assessed in the following manner:

....

(2) This Subsection shall not apply if the claim is reasonably
controverted or if such nonpayment results from conditions over
which the employer or insurer had no control.

....

(4) In the event that the health care provider prevails on a
claim for payment of his fee, penalties as provided in this Section and
reasonable attorney fees based upon actual hours worked may be
awarded and paid directly to the health care provider. This
Subsection shall not be construed to provide for recovery of more than
one penalty or attorney fee.

A workers’ compensation claim has been “reasonably controverted” if the

employer/insurer “possessed factual and/or medical information to reasonably

counter the factual and medical information presented by the claimant[.]” Brown v.

Texas-LA Cartage, Inc., 98-1063, p. 9 (La. 12/1/98), 721 So.2d 885, 890. Stated

another way, the employer/insurer “must have some valid reason or evidence upon

which to base [its] denial of benefits.” Id. Furthermore, the decision to cast an

employer with penalties and attorney fees is a question of fact subject to the

11

manifest error standard of review. Brown v. Lafayette Ass’n of Retarded Citizens,

Inc., 11-1595 (La.App. 3 Cir. 6/20/12), 94 So.3d 950.

The WCJ, a three-judge panel of this court, and a divided supreme court

considered the novel legal issues raised in this matter (the definition of a health

care provider, the assignability of workers’ compensation claims, and the novation

of the agency agreement) and reached different conclusions on the merits. Given

this background, we find that LUBA reasonably controverted the claims at issue.

Such a finding also precludes a finding that LUBA was arbitrary and capricious in

failing to pay the claims at issue. We find no manifest error in the WCJ’s denial of

penalties and attorney fees and no merit in this assignment of error.

LUBA’s Remaining Issues on Appeal

In its answer to the appeal, LUBA asserted that the WCJ erred in granting

Rebel Distributors/Physician Partner a new trial even after it had rejected the

motion for new trial. In both its answer to the appeal and its assignments of error,

LUBA asserted that the WCJ erred in rejecting its exception of res judicata.

Finally, in its remaining assignment of error, LUBA asserts that the WCJ erred in

signing a second judgment rejecting its exceptions and summary judgment after

having, on the day before, signed a judgment rejecting the motion for new trial

filed by Rebel Distributors/Physician Partner.

While we did not directly address this issue in our original opinion, we set

forth what we construed as the procedural history related to the new trial issue and,

in doing so, stated the following:

The trial record before us presents a most confusing procedural
history, and the minutes of the various hearings are woefully lacking
in detail concerning what issue the WCJ considered on a given day in
court as well as the disposition of that issue. Our understanding of the
record is that on July 16, 2010, the WCJ granted the initial peremptory
exception of no right of action filed by Acadiana/LUBA in the
12

response to the original Form 1008, despite having allowed the first
amendment to the original Form 1008 the day before. We interpret
this action to mean that the WCJ concluded that the change of the
plaintiff’s identification to Rebel Distributors/Physician Partner was
not sufficient to cure the defect raised by the exception of no right of
action, and we agree with that conclusion. We also agree that the
WCJ had full authority to grant Rebel Distributors/Physician Partner
and/or Physician Partner forty-five days to amend the claim to state a
right of action. See La.Code Civ.P. art. 934. Judgment granting the
exception of no right of action was signed by the WCJ on August 12,
2010, and the forty-five days began to run from that day. However,
before the forty-five days had run, Rebel Distributors/Physician
Partner timely filed a motion for new trial. Additionally, before the
motion was ruled upon, Rebel Distributors/Physician Partner filed its
second amendment to the original Form 1008 and provided the WCJ
with the November 16, 2010 agreement.

As we appreciate the WCJ’s actions with regard to the
December 15, 2010 hearing and the written judgments arising from
that hearing, the WCJ combined all of the prior issues with issues not
yet heard and disposed of everything at one time. To reconcile the
actions of the WCJ in this regard, it is necessary to consider each
ruling independently of the other.

We conclude that the WCJ’s denial of Physician Partner’s
motion for new trial was rendered before the consideration of any of
the other pending issues. That is to say, the first amendment to the
original Form 1008 did not establish that Physician Partner or the
newly named plaintiff, Rebel Distributors/Physician Partner was the
right party to institute this action. Thus, the WCJ concluded that a
distributor or packager of pharmaceuticals who has been assigned the
ownership of the claim of a licensed Louisiana physician cannot
maintain an action under the Louisiana Workers’ Compensation law,
because neither is a health care provider as defined in La.R.S.
23:1021(6).

We read the record to conclude that having made that decision,
the WCJ then ordered that the second amendment of the original Form
1008 be filed. The WCJ then concluded that the filing and the
November 16, 2010 agreement retroactively changed the June 29,
2007 agreement to one of agency, and that the agent (Rebel
Distributors/Physician Partner) could bring this action on behalf of its
principal (Dr. Heard/Clinic). Declaring the capacity defect cured, the
WCJ then rejected the exceptions of no right and no cause of action
and the motion for summary judgment filed by Acadiana/LUBA.

Rebel Distribs., 129 So.3d at 90-91.

13

The judgments complained of by LUBA arise from this same convoluted

procedural history. As stated in our prior opinion:

In a written judgment executed on February 21, 2011, the WCJ
denied the motion for new trial filed by Physician Partner and granted
Rebel Distributors’/Physician Partner’s motion to file the second
supplementation and amendment of the original Form 1008. On that
same day, the WCJ executed a separate order granting a January 19,
2011 motion filed by Rebel Distributors/Physician Partner to
consolidate eighteen other cases with the instant case. The next day,
the WCJ issued a second judgment denying Acadiana’s/LUBA’s
motion for summary judgment, its exception of no cause of action,
and its exception of no right of action.

Id. at 87.

We continue to construe the procedural history in this manner and find no

merit in any of LUBA’s remaining arguments on appeal.

DISPOSITION

For the foregoing reasons, we affirm the judgment of the workers’

compensation judge in all respects. The costs of this appeal are assessed equally

between the plaintiff, Rebel Distributors Corp., Inc. d/b/a Physician Partner and

Pharmacy Partner, and the defendants, LUBA Casualty Insurance Company and

Acadiana Plastics Manufacturing, Inc.

AFFIRMED.

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STATE OF LOUISIANA
COURT OF APPEAL, THIRD CIRCUIT

12-909 consolidated with 12-910, 12-911, 12-912, 12-913, 12-914, 12-915,
12-916, 12-917, 12-918, 12-919, 12-920, 12-921, 12-922,
12-925, 12-926, and 12-927

REBEL DISTRIBUTORS CORP., INC. d/b/a PHYSICIAN PARTNER AND
PHARMACY PARTNER (MARY DOUCET)

VERSUS

LUBA WORKERS’ COMP., ET AL.

THIBODEAUX, Chief Judge, dissenting in part.

The majority affirms the judgment of the Office of Workers’

Compensation limiting the payment of the outstanding pharmacy bill to $750.00

pursuant to La.R.S. 23:1142. In my view, that is erroneous.

Louisiana Revised Statutes 23:1142(B)(1) and (B)(2)(a) repeatedly

refer to “diagnostic testing” and “treatment.” It does not, as the majority opinion

concedes, include prescription medication as part of nonemergency diagnostic

testing or treatment. The diagnostic testing and treatment are the only matters that

are subject to the $750.00 cap, not medication.

The more specific provisions of Part II of Chapter 10 entitled

“Benefits” should properly apply. Louisiana Revised Statutes 23:1203(A)(B)(D)

and (E) all specifically refer to “drugs,” “supplies,” or “services.” The majority, in

my view, is interpreting La.R.S. 23:1203 much too restrictively and focuses undue

attention on references to “employer” and “employee.”

For the foregoing reasons, I respectfully dissent in part.