Louisiana 2018 2018 Regular Session

Louisiana Senate Bill SB507 Comm Sub / Analysis

                    The original instrument and the following digest, which constitutes no part of the
legislative instrument, were prepared by Christine Arbo Peck.
DIGEST
SB 507 Original	2018 Regular Session	Mills
Proposed law provides that a Medicaid managed care organization shall be liable to a provider for
payment of claims to the provider when the provider followed instructions of the managed care
organization to his detriment and did not act with fault or fraudulent intent regarding enrollment,
credentialing, or accreditation. 
Proposed law provides that a Medicaid managed care organization shall be liable to the state for any
payment to providers when the provider acts with fault or fraudulent intent regarding enrollment,
credentialing, or accreditation. 
Proposed law requires the managed care organization to cover the expense of reimbursement to the
provider or to the state from the administrative funding allocated to the managed care organization.
Proposed law requires the Louisiana Department of Health to impose monetary sanctions on the
Medicaid managed care plan for the infractions established in proposed law in accordance with rules
and regulations promulgated pursuant to the Administrative Procedure Act.
Proposed law gives the attorney general authority to investigate, enforce, and seek recoupment from
the Medicaid managed care plans. Proposed law deposits monies received from the Medicaid
managed care plans into the Medical Assistance Programs Fraud Detection Fund.
Effective August 1, 2018.
(Adds R.S. 46:460.72)