HLS 18RS-542 ENGROSSED
2018 Regular Session
HOUSE BILL NO. 163
BY REPRESENTATIVE MACK
MEDICAID: Creates the Medicaid Recipient Fraud Unit within the office of the attorney
general
1 AN ACT
2To enact R.S. 46:440.4, relative to Medicaid recipient fraud; to create the Medicaid
3 Recipient Fraud Unit within the office of the attorney general; to provide for
4 administration and duties of the unit and funding of its activities; to provide relative
5 to reporting and review of Medicaid recipient fraud complaints; to provide for duties
6 of the Louisiana Department of Health with respect to Medicaid program integrity;
7 to provide for legislative intent; and to provide for related matters.
8Be it enacted by the Legislature of Louisiana:
9 Section 1. R.S. 46:440.4 is hereby enacted to read as follows:
10 ยง440.4. Medicaid Recipient Fraud Unit; creation; administration
11 A. It is the intent of the legislature that the office of the attorney general and
12 the Louisiana Department of Health, referred to hereafter in this Section as the
13 "department", work cooperatively to detect, investigate, and prosecute Medicaid
14 recipient fraud within the medical assistance programs of this state. In furtherance
15 of this goal, the office of the attorney general and the department are hereby directed
16 to execute all agreements necessary to implement the provisions of this Section.
17 B. The legislature hereby creates the Medicaid Recipient Fraud Unit,
18 referred to hereafter in this Section as the MRFU, within the criminal division of the
19 office of the attorney general. The MRFU shall be responsible for operating a
20 statewide program for the investigation and prosecution of violations of any
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HLS 18RS-542 ENGROSSED
HB NO. 163
1 applicable state law regarding any aspect of fraud in connection with any aspect of
2 the receipt of medical assistance under Title XIX of the Social Security Act.
3 C. The MRFU shall be deemed an extension of the Medicaid program
4 integrity function of the department and shall be funded through the appropriation
5 to the department for administration of the Medicaid program. The attorney general
6 shall work with the department in preparing the annual budget for the MRFU.
7 D. The department shall perform a preliminary review of all Medicaid
8 recipient fraud complaints reported to it pursuant to 42 CFR 455.14. For each
9 complaint for which there appears to be a credible allegation of fraud, the department
10 shall refer that complaint to the MRFU for a complete investigation and prosecution
11 pursuant to the procedures agreed to by the attorney general and the department.
12 E. The attorney general shall submit quarterly reports, in a form agreed to
13 by the office of the attorney general and the department, notifying the department of
14 the status and disposition of Medicaid recipient fraud matters handled by the MRFU.
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 163 Engrossed 2018 Regular Session Mack
Abstract: Creates the Medicaid Recipient Fraud Unit within the office of the attorney
general and provides for administration, duties, and funding of the unit.
Proposed law expresses the intent of the legislature that the office of the attorney general and
the La. Department of Health (LDH) work cooperatively to detect, investigate, and prosecute
Medicaid recipient fraud.
Proposed law creates the Medicaid Recipient Fraud Unit (MRFU) within the criminal
division of the office of the attorney general. Requires that the MRFU be responsible for
operating a statewide program for the investigation and prosecution of violations of present
law regarding any aspect of fraud in connection with any aspect of the receipt of Medicaid
benefits.
Proposed law deems the MRFU an extension of the Medicaid program integrity function of
LDH.
Proposed law provides that the MRFU shall be funded through the appropriation to LDH for
administration of the Medicaid program. Stipulates that the attorney general shall work with
LDH in preparing the annual budget for the MRFU.
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HLS 18RS-542 ENGROSSED
HB NO. 163
Proposed law requires LDH to perform a preliminary review of all Medicaid recipient fraud
complaints reported to it pursuant to federal Medicaid regulations, 42 CFR 455.14. Provides
that for each complaint for which there appears to be a credible allegation of fraud, LDH
shall refer that complaint to the MRFU for investigation and prosecution.
Proposed law requires the attorney general to submit quarterly reports notifying LDH of the
status and disposition of Medicaid recipient fraud matters handled by the MRFU.
(Adds R.S. 46:440.4)
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.