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)]
HB 89 Original 2016 First Extraordinary Session Stokes
Abstract: Provides relative to uses of monies dedicated to the Medical Assistance Programs Fraud
Detection Fund and for allocation of fund monies among the attorney general, the Dept. of
Health and Hospitals (DHH), and the legislative auditor.
Present law establishes the Medical Assistance Programs Fraud Detection Fund and authorizes
purposes for which monies in the fund may be used. Proposed law retains present law.
Present law provides for the following allocation of monies in the fund:
(1)50% shall be allocated to the Medicaid Fraud Control Unit within the office of the attorney
general.
(2)50% shall be allocated to DHH to be used solely for Medicaid fraud detection and for
purposes specified in present law.
Proposed law revises present law to add the legislative auditor as an entity which may utilize monies
in the fund, and to provide for the following allocation of such monies:
(1)45% shall be allocated to the Medicaid Fraud Control Unit within the office of the attorney
general.
(2)45% shall be allocated to DHH to be used solely for Medicaid fraud detection and for
purposes specified in present law and proposed law.
(3)10% shall be allocated to the legislative auditor to be used solely for Medicaid fraud
detection and for purposes specified in present law and proposed law.
Present law provides that the monies in the fund shall not be used to replace, displace, or supplant
state general funds appropriated for the daily operation of DHH or the Medicaid program, and may
be appropriated by the legislature only for certain enumerated purposes. Proposed law retains
present law, and adds performance of any of the following functions with respect to Medicaid
managed care organizations as authorized uses of fund monies:
(1)Validation of claims data received by managed care organizations.
(2)Analysis of claim integrity units of managed care organizations. (3)Review of actuarial assumptions and methods.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Amends R.S. 46:440.1(C)-(E); Adds R.S. 46:440.1(F))