ENROLLED
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CODING: Words in struck through type are deletions from existing law; words underscored
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ACT No. 632
Regular Session, 2010
HOUSE BILL NO. 1483 (Substitute for House Bill No. 1360 by Representative Wooton)
BY REPRESENTATIVE WOOTON
AN ACT1
To amend and reenact R.S. 22:1924(A)(1) and to enact R.S. 22:1924(A)(3), relative to2
insurance fraud; to provide definitions; to establish penalties for knowingly and3
willfully committing health care fraud; and to provide for related matters.4
Be it enacted by the Legislature of Louisiana:5
Section 1. R.S. 22:1924(A)(1) is hereby amended and reenacted and R.S.6
22:1924(A)(3) is hereby enacted to read as follows: 7
ยง1924. Prohibited activities and sanctions8
A.(1) Any person who, with the intent to injure, defraud, or deceive any9
insurance company, or the Department of Insurance, or any insured or other party in10
interest, or any third-party claimant commits any of the acts specified in Paragraph11
(2) or (3) of this Subsection is guilty of a felony and shall be subjected to a term of12
imprisonment, with or without hard labor, not to exceed five years, or a fine not to13
exceed five thousand dollars, or both, on each count and payment of restitution to the14
victim company of any insurance payments to the defendant that the court15
determines was not owed and the costs incurred by the victim company associated16
with the evaluation and defense of the fraudulent claim, including but not limited to17
the investigative costs, attorney fees, and court costs. However, if the benefit18
pursued does not exceed one thousand dollars, the term of imprisonment shall not19
exceed six months, or the fine shall not exceed one thousand dollars, or both, on each20
count.21
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(3)(a) Knowingly and willfully committing health care fraud shall be23
punishable as provided in Paragraph (1) of this Subsection.24 ENROLLEDHB NO. 1483
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(b) "Health care fraud" shall mean, in conjunction with the delivery of or1
payment for health care benefits, items, or services:2
(i) To execute a scheme or artifice to defraud any health care benefit3
program.4
(ii) To obtain, by means of fraudulent claims, or false or fraudulent5
pretenses, representations, or promises, any of the money or property owned by, or6
under the custody or control of, any health care benefit program.7
(c) For the purposes of this Paragraph, "knowingly and willfully" shall mean8
to continue with a practice, after written notice to cease such practice from a health9
care benefit program by certified mail, return receipt requested, except when the10
health care provider reasonably believes that such practice materially complies with11
coding or billing standards as issued by the American Medical Association, the12
United States Department of Health and Human Services, the Centers for Medicare13
and Medicaid Services, or the Louisiana Medicaid Program.14
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SPEAKER OF THE HOUSE OF REPRESENTATI VES
PRESIDENT OF THE SENATE
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED: