HLS 10RS-1463 ORIGINAL
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
Regular Session, 2010
HOUSE BILL NO. 1219
BY REPRESENTATIVE KLECKLEY
INSURANCE/HEALTH-ACCI D: Provides relative to the licensure, financial solvency, and
regulation of prepaid entities participating in the La. Medicaid Program
AN ACT1
To enact R.S. 22:1016, relative to prepaid entities participating in the Louisiana Medicaid2
Program; to provide for licensure, financial solvency, and regulation of such prepaid3
entities; and to provide for related matters.4
Be it enacted by the Legislature of Louisiana:5
Section 1. R.S. 22:1016 is hereby enacted to read as follows: 6
§1016. Regulation by the Department of Insurance and the Department of Health7
and Hospitals of prepaid entities participating in the Louisiana Medicaid8
Program9
A. Notwithstanding any law to the contrary, any prepaid entity that10
participates in the Louisiana Medicaid Program is required to obtain an insurer11
license or certificate of authority from the Louisiana Department of Insurance. Such12
a prepaid entity participating in the Louisiana Medicaid Program shall be regulated13
by the Louisiana Department of Insurance with respect to licensure and financial14
solvency but shall, solely with respect to its products and services offered pursuant15
to the Louisiana Medicaid Program, be regulated by the Louisiana Department of16
Health and Hospitals, subject to 42 USCA §1396 et seq., and all applicable federal17
and state laws, rules, and regulations relating to the Louisiana Medicaid Program.18
The Louisiana Department of Health and Hospitals shall have the authority to adopt19
and promulgate such rules and regulations, including certification, relating to the20 HLS 10RS-1463 ORIGINAL
HB NO. 1219
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are additions.
Louisiana Medicaid Program. Except for licensure and financial solvency1
requirements, no other provisions of this Title shall apply to a prepaid entity with2
respect to the participation of the prepaid entity in the Louisiana Medicaid Program.3
B. As used in this Section, "prepaid entity" shall mean any organization paid4
on a per-person per-month basis for the provision of services to Medicaid eligible5
beneficiaries, when such organization has entered into a contract with the6
Department of Health and Hospitals assuming the financial obligation to pay for such7
services.8
Section 2. This Act shall become effective upon signature by the governor or, if not9
signed by the governor, upon expiration of the time for bills to become law without signature10
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If11
vetoed by the governor and subsequently approved by the legislature, this Act shall become12
effective on the day following such approval.13
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Kleckley HB No. 1219
Abstract: Provides relative to the regulation of certain prepaid entities participating in the
La. Medicaid Program by the Dept. of Insurance and the Dept. of Health and
Hospitals.
Proposed law provides that, notwithstanding any law to the contrary, any prepaid entity that
participates in the La. Medicaid Program is required to obtain an insurer license or certificate
of authority from the La. Dept. of Insurance (DOI). Requires that such a prepaid entity be
regulated by DOI with respect to licensure and financial solvency; however, solely with
respect to its products and services offered pursuant to the La. Medicaid Program, such an
entity shall be regulated by the La. Department of Health and Hospitals (DHH), subject to
all applicable federal and state laws, rules, and regulations relating to the La. Medicaid
Program. Authorizes DHH to adopt and promulgate such rules and regulations, including
certification, relating to the La. Medicaid Program. Specifies that, except for licensure and
financial solvency requirements, no other provisions of present law, the La. Insurance Code,
shall apply to a prepaid entity with respect to its participation in the La. Medicaid Program.
Defines "prepaid entity"as any organization paid on a per-person per-month basis for the
provision of services to Medicaid eligible beneficiaries, when such organization has entered
into a contract with DHH assuming the financial obligation to pay for such services.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Adds R.S. 22:1016)