ENROLLED
ACT No. 21
2015 Regular Session
HOUSE BILL NO. 270
BY REPRESENTATIVE ARMES
1 AN ACT
2 To amend and reenact R.S. 46:460.51(introductory paragraph) and the heading of Subpart
3 B of Part XIII of Chapter 3 of Title 46 of the Louisiana Revised Statutes of 1950, and
4 to enact R.S. 46:442 and 460.70, relative to the medical assistance program of this
5 state, known also as Medicaid; to prescribe duties of the Department of Health and
6 Hospitals in administering the Medicaid program; to provide relative to Medicaid
7 managed care organizations; to provide relative to provider claims for certain health
8 services; and to provide for related matters.
9 Be it enacted by the Legislature of Louisiana:
10 Section 1. R.S. 46:460.51(introductory paragraph) and the heading of Subpart B of
11 Part XIII of Chapter 3 of Title 46 of the Louisiana Revised Statutes of 1950 are hereby
12 amended and reenacted and R.S. 46:442 and 460.70 are hereby enacted to read as follows:
13 §442. Medicaid provider claims; period for filing
14 In administering the Medicaid program of this state, the Department of
15 Health and Hospitals shall not limit the period within which a health care provider
16 may submit a claim for payment for a covered service rendered to a Medicaid
17 program enrollee to less than three hundred sixty-five days from the date the service
18 was provided.
19 * * *
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1 §460.51. Definitions
2 The As used in this Part, the following terms shall have the following
3 meanings meaning ascribed in this Section unless the context clearly indicates
4 otherwise:
5 * * *
6 SUBPART B. CLAIM FILING AND PAYMENT
7 §460.70. Timely filing of claims
8 In accordance with the provisions of R.S. 46:442, the department shall not
9 limit the period within which a provider may submit a claim for payment for a
10 covered service rendered to an enrollee to less than three hundred sixty-five days
11 from the date the service was provided. This prohibition on limiting the claim
12 submission period to less than three hundred sixty-five days from the date of service
13 shall apply relative to claims submitted directly to the department and to claims
14 submitted to all of the following entities:
15 (1) A managed care organization.
16 (2) Any of the following entities as defined in 42 C.F.R. 438.2:
17 (a) A prepaid ambulatory health plan.
18 (b) A prepaid inpatient health plan.
19 (c) A primary care case manager.
20 Section 2.(A) The Louisiana State Law Institute is hereby directed to designate R.S.
21 46:460.51 and 460.52 as Subpart A of Part XIII of Chapter 3 of Title 46 of the Louisiana
22 Revised Statutes of 1950, and is further directed to entitle the Subpart "General Provisions".
23 (B) The Louisiana State Law Institute is hereby directed to redesignate Subpart A
24 of Part XIII of Chapter 3 of Title 46 of the Louisiana Revised Statutes of 1950, comprised
25 of R.S. 46:460.61 and 460.62, as Subpart B of Part XIII of Chapter 3 of Title 46 of the
26 Louisiana Revised Statutes of 1950, and is further directed to retain the heading of the
27 Subpart.
28 (C) The Louisiana State Law Institute is hereby directed to redesignate Subpart B
29 of Part XIII of Chapter 3 of Title 46 of the Louisiana Revised Statutes of 1950, comprised
30 of R.S. 46:460.70 as enacted by Section 1 of this Act and R.S. 46:460.71, as Subpart C of
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1 Part XIII of Chapter 3 of Title 46 of the Louisiana Revised Statutes of 1950, and is further
2 directed to entitle the Subpart "Claim Filing And Payment".
SPEAKER OF THE HOUSE OF REPRESENTATIVES
PRESIDENT OF THE SENATE
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED:
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