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Court upholds fee schedule cap on reimbursement for pot

Posted On: Oct. 19, 2022 9:19 AM CST


The New Mexico Court of Appeals said an injured worker wasn’t entitled to full reimbursement for his out-of-pocket medical cannabis costs because they exceeded the maximum payment allowed under the state’s medical fee schedule.

Rodolfo Barrozo Jr. injured his wrists and elbows while working for grocery chain Albertsons Inc. and qualified for medical cannabis under the state’s compassionate use laws, according to Rodolfo Barrozo Jr. v. Albertsons Inc. and Ace American Insurance Co.

Mr. Barrozo requested that Albertsons and its insurer Ace American Insurance Co. reimburse the full $453.05 he paid for medical cannabis. He was reimbursed $108.18 under the state’s medical fee schedule.

A workers compensation judge denied Mr. Barrozo’s appeal and agreed that the reimbursement was properly calculated in accordance with fee schedule rates.

In dismissing his appeal, the New Mexico Court of Appeals rejected Mr. Barrozo’s arguments that the requirement that employers provide injured workers with health care services entitled him to full reimbursement and that the cap on reimbursement in the fee schedule conflicted with a statutory requirement that employers cover the full cost of medical treatment for injured workers.

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