HLS 10RS-1519 ORIGINAL
Page 1 of 4
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
Regular Session, 2010
HOUSE BILL NO. 852
BY REPRESENTATIVE PUGH
MEDICAID: Removes the prohibition against nonaccredited facilities receiving payment
from a state agency or Medicaid reimbursement for certain services
AN ACT1
To amend and reenact R.S. 39:1659, the heading of Part LXV of Chapter 5 of Title 40 of the2
Louisiana Revised Statutes of 1950, and R.S. 40:1300.281(A), (C), and (D) and to3
repeal R.S. 40:1300.281(B)(2) and (3), relative to prosthetic and orthotic services;4
to remove the requirement that state agencies only purchase orthoses and orthotic5
services from an accredited facility; to remove the definition of orthoses and orthotic6
services; to remove the prohibition against reimbursement from the state Medicaid7
program for certain services; to remove the penalty assessed against nonaccredited8
facilities and the required reimbursement to state agencies or the Medicaid program9
for the provision of certain services; and to provide for related matters.10
Be it enacted by the Legislature of Louisiana:11
Section 1. R.S. 39:1659 is hereby amended and reenacted to read as follows:12
§1659. Purchase of prostheses, orthoses, and prosthetic services, and orthotic13
services by a state agency from an accredited facility14
Notwithstanding any other provision of law to the contrary, regulations15
promulgated by the commissioner of administration or other purchasing entity16
governing the purchase of prostheses, orthoses, or prosthetic services, or orthotic17
services shall require that such services shall only be purchased from an accredited18
facility as provided in R.S. 40:1300.281. However, nothing in this Section shall19
prohibit a licensed occupational therapist or a licensed physical therapist from20
practicing within his scope of practice. In addition, the provisions of this Section21
shall not apply to a licensed optometrist or ophthalmologist. 22 HLS 10RS-1519 ORIGINAL
HB NO. 852
Page 2 of 4
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
Section 2. The heading of Part LXV of Chapter 5 of the Title 40 of the Louisiana1
Revised Statutes of 1950 and R.S. 40:1300.281(A), (C), and (D) are hereby amended and2
reenacted to read as follows: 3
PART LXV. PROSTHETICS AND ORTHOTICS 4
FROM ACCREDITED FACILITIES5
§1300.281. Purchase of prostheses, orthoses, and prosthetic services, and orthotic6
services by a state agency from an accredited facility; Medicaid7
reimbursement; definitions; penalties8
A.(1) Any state agencies which utilize funds to pay for prostheses , orthoses,9
or prosthetic services, or orthotic services shall only purchase such services ,10
prostheses, or orthoses from an accredited facility.11
(2) No reimbursements from the state Medicaid program shall be paid for12
prostheses, orthoses, or prosthetic services, or orthotic services except to an13
accredited facility.14
* * *15
C. Any person who does not provide services from an accredited facility as16
defined in Paragraph (1) of Subsection B, or any organization or facility which is not17
accredited as defined in Paragraph (1) of Subsection B, and accepts payment from18
a state agency for prostheses, orthoses, or prosthetic services, or orthotic services19
shall be fined twenty-five hundred dollars per violation and shall reimburse the state20
agency for the cost of the prostheses, orthoses, or services.21
D. Any person who does not provide services from an accredited facility as22
defined in Paragraph (1) of Subsection B, or any organization or facility which is not23
accredited as defined in Paragraph (1) of Subsection B, and is reimbursed from the24
state Medicaid program for prostheses, orthoses, or prosthetic services, or orthotic25
services shall be fined twenty-five hundred dollars per violation and shall reimburse26
the state Medicaid program for the cost of the prostheses, orthoses, or services.27
* * *28 HLS 10RS-1519 ORIGINAL
HB NO. 852
Page 3 of 4
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
Section 3. R.S. 40:1300.281(B)(2) and (3) are hereby repealed in their entirety.1
Section 4. This Act shall become effective upon signature by the governor or, if not2
signed by the governor, upon expiration of the time for bills to become law without signature3
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If4
vetoed by the governor and subsequently approved by the legislature, this Act shall become5
effective on the day following such approval.6
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)]
Pugh HB No. 852
Abstract: Removes the prohibition against state agency payments and Medicaid
reimbursements to nonaccredited facilities for certain services.
Present law (R.S. 39:1659) requires the purchase of prostheses, orthoses, prosthetic services,
and orthotic services by a state agency from an accredited facility as defined in present law.
However, present law does not prohibit a licensed occupational therapist or a licensed
physical therapist from practicing within his scope of practice. Additionally, present law
does not apply to a licensed optometrist or ophthalmologist.
Proposed law removes the requirement that state agencies only purchase orthoses and
orthotic services from an accredited facility.
Present law (R.S. 40:1300.281(A)) requires that state agencies which utilize funds to pay for
prostheses, orthoses, prosthetic services, or orthotic services only purchase such services
from an accredited facility. Only an accredited facility shall receive reimbursements from
the state Medicaid program for prostheses, orthoses, prosthetic services, or orthotic services.
Proposed law removes the requirement that state agencies only purchase orthoses and
orthotic services from an accredited facility. Also, removes the prohibition against
Medicaid reimbursement applicable to orthoses and orthotic services.
Present law (R.S. 40:1300.281(B)(2) and (3)) defines "orthosis" as a custom fabricated brace
or support that is designed based on medical necessity. Specifies that orthoses does not
include prefabricated or direct-formed orthotic devices, or any of the following assistive
technology devices: commercially available knee orthoses used following injury or surgery,
upper extremity adaptive equipment, finger splints, hand splints, wrist gauntlets, face masks
used following burns, wheelchair seating that is an integral part of the wheelchair and not
worn by the patient independent of the wheelchair, fabric or elastic supports, corsets, low-
temperature formed plastic splints, trusses, elastic hose, canes, crutches, cervical collars, and
dental appliances, such as those commonly carried in stock by a pharmacy, department store,
corset shop, or surgical supply facility. Also, defines "orthotic services" as the science and
practice of evaluating, measuring, designing, fabricating, assembling, fitting, adjusting, or
servicing of an external device for the support, correction, or alleviation of neuromuscular
or musculoskeletal dysfunction, disease, injury, or deformity. Also, provides that orthotic
practice provides continuing patient care in order to assure proper fit and function of the
orthotic device by periodic evaluation. HLS 10RS-1519 ORIGINAL
HB NO. 852
Page 4 of 4
CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
Proposed law repeals present law.
Present law (R.S. 40:1300.281(C)) establishes a penalty of $2,500 per violation for any
facility that is not accredited and accepts payment from a state agency for prostheses,
orthoses, prosthetic services, or orthotic services and requires that they reimburse the state
agency for the cost of such services.
Proposed law removes the per violation penalty imposed against nonaccredited facilities that
accept payments from state agencies for orthoses and orthotic services and removes the
requirement that they reimburse the state agency for the cost of such services.
Present law (R.S. 40:1300.281(D)) establishes a penalty of $2,500 per violation for any
facility that is not accredited and is reimbursed from the state Medicaid program for
prostheses, orthoses, prosthetic services, or orthotic services and requires that they reimburse
the Medicaid program for the cost of such services.
Proposed law removes the per violation penalty imposed against nonaccredited facilities that
are reimbursed from Medicaid for orthoses and orthotic services and removes the
requirement that they reimburse the Medicaid program for the cost of such services.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Amends R.S. 39:1659, the heading of Part LXV of Chapter 5 of Title 40 of the L.R.S. of
1950, and R.S. 40:1300.281(A), (C), and (D); Repeals R.S. 40:1300.281(B)(2) and (3))