reglab/housing_qa huggingface dataset:
LA Rev Stat § 46:440.6 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§440.6. Purposes of the task force

RS 440.6 - Purposes of the task force  The purposes of the task force shall include the following:  (1) To study and evaluate on an ongoing basis the laws, rules, policies, and processes by which the state implements Medicaid fraud detection and prevention efforts.  (2) To identify and recommend opportunities for improving coordination of Medicaid fraud detection and prevention initiatives across state agencies and branches of state government.  (3) To identify any systemic or systemwide issues of concern within the Medicaid program with respect to fraud, waste, and abuse.  (4) To develop recommendations for policies and procedures by which to facilitate and implement all of the following:  (a) Random sampling of Medicaid cases to be selected for verification of enrollee eligibility.  (b) Improvements in the Medicaid program integrity functions of the Louisiana Department of Health.  (c)(i) Optimization of data mining among state-owned data sets for purposes of Medicaid fraud detection and prevention.  (ii) For purposes of this Subparagraph, "data mining" means the practice of electronically sorting data through statistical modeling, intelligent technologies, and other methods in order to uncover patterns, relationships, and other indicators of actual or potential Medicaid fraud, waste, or abuse.  (5) To make reports to the governor and to the legislature in accordance with R.S. 46:440.7.  Acts 2017, No. 420, §1.  NOTE: See R.S. 46:440.8 regarding termination of Subpart on Aug. 1, 2019.
LA Rev Stat § 46:440.7 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§440.7. Reporting

RS 440.7 - Reporting  A. On or before January 1, 2018, and semiannually thereafter, the task force shall prepare and submit to the governor and the legislature a report concerning the status of Medicaid fraud detection and prevention initiatives and the status of efforts to coordinate such initiatives across state agencies and branches of state government.  B. At minimum, the report required by this Section shall include information, analysis, and commentary related to each purpose of the task force enumerated in R.S. 46:440.6, and may include any other information as the task force deems necessary or appropriate.  Acts 2017, No. 420, §1.  NOTE: See R.S. 46:440.8 regarding termination of Subpart on Aug. 1, 2019.
LA Rev Stat § 46:440.8 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§440.8. Termination

RS 440.8 - Termination  The provisions of this Subpart shall terminate on August 1, 2019.  Acts 2017, No. 420, §1; Acts 2018, No. 294, §1.  NOTE: See R.S. 46:440.8 regarding termination of Subpart on Aug. 1, 2019.
LA Rev Stat § 46:440.11 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§440.11. Legislative findings; declaration; purpose

RS 440.11 - Legislative findings; declaration; purpose A. The legislature hereby finds all of the following: (1) States are required to implement provisions of the Patient Protection and Affordable Care Act, comprised of Public Laws 111-148 and 111-152, relative to Medicaid recovery audit contractors. (2) The recovery audit function is a useful tool for improving Medicaid program integrity and ensuring that public monies are used for appropriate and necessary healthcare services. (3) Healthcare providers are subject to numerous audits from the state and federal health agencies and reviews by Medicaid managed care companies which result in increased administrative costs that raise costs to all healthcare consumers. B. The legislature hereby declares that simplifying and standardizing Medicaid recovery audit functions is necessary and in the best interest of this state. Therefore, the purpose of this Subpart is to provide for greater Medicaid program integrity by establishing a standardized recovery audit contractor program. Acts 2014, No. 568, §1, eff. Aug. 15, 2014.
LA Rev Stat § 46:440.12 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§440.12. Definitions

RS 440.12 - Definitions  As used in this Subpart, the following terms have the meaning ascribed in this Section:  (1) "Adverse determination" means any decision rendered by the recovery audit contractor that results in a payment to a provider for a claim or service being reduced either partially or completely.  (2) "Contractor" and "recovery audit contractor" mean a Medicaid recovery audit contractor selected by the department to perform audits for the purpose of ensuring Medicaid program integrity in accordance with the provisions of 42 CFR 455 et seq.  (3) "Department" means the Louisiana Department of Health.  (4) "Medicaid" and "medical assistance program" mean the medical assistance program provided for in Title XIX of the Social Security Act.  (5) "Provider" means any healthcare entity enrolled with the department as a provider in the Medicaid program.  Acts 2014, No. 568, §1, eff. Aug. 15, 2014.
LA Rev Stat § 46:440.13 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§440.13. Recovery audit contractor program established; rulemaking

RS 440.13 - Recovery audit contractor program established; rulemaking A. There is hereby established within the department a recovery audit contractor program. The program shall adhere to the requirements provided in this Subpart. B. The department shall promulgate all rules in accordance with the Administrative Procedure Act and shall submit all Medicaid state plan amendments as are necessary to implement the provisions of this Subpart. Acts 2014, No. 568, §1, eff. Aug. 15, 2014.
LA Rev Stat § 46:440.15 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§440.15. Healthcare provider appeals process

RS 440.15 - Healthcare provider appeals process A. A provider shall have a right to the informal and formal appeals processes for determinations made by the recovery audit contractor as provided in this Section. B. The contractor shall establish an informal appeals process that conforms with all of the following guidelines: (1) From the date of receipt of the initial findings letter by the contractor, there shall be an informal discussion and consultation period wherein the provider and contractor may communicate regarding any determinations for reasons including but not limited to policies, criteria, and program rules pertinent to the determination. (2)(a) Within forty-five days of receipt of a notification of an adverse determination from the contractor, a provider shall have the right to request an informal hearing of such findings, or a portion thereof, with the contractor and the Medicaid program integrity division of the department by submitting a request in writing to the contractor. (b) The informal hearing provided for in this Paragraph shall occur within thirty days of the provider's request. (c) At the informal hearing, the provider shall have all of the following rights: (i) The right to present information orally and in writing. (ii) The right to present documents. (iii) The right to have the department and the contractor address any inquiry the provider may make concerning the reason for the adverse determination. (d) A provider may be represented by an attorney or authorized representative at the informal hearing if written notice of representation identifying the attorney or representative is submitted with the request for the informal hearing. (3) The contractor and medical assistance program integrity division of the department shall issue a final decision related to the informal appeal to the provider within fifteen days of the closure of the appeal. C. Within thirty days of the issuance of a final decision or determination pursuant to an informal appeal conducted in accordance with Subsection B of this Section, a provider may request an administrative appeal of the final decision by requesting a hearing before the health and hospitals section of the division of administrative law and providing a copy of the appeal to the Medicaid program integrity division of the department. Acts 2014, No. 568, §1, eff. Aug. 15, 2014.
LA Rev Stat § 46:440.16 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§440.16. Contractor performance oversight; penalties; protections

RS 440.16 - Contractor performance oversight; penalties; protections A. If more than twenty-five percent of the contractor's adverse determinations are overturned on appeal in any six-month period, then the House Committee on Health and Welfare and the Senate Committee on Health and Welfare, jointly, shall hold an oversight hearing to evaluate the contractor's performance and provide the medical assistance program with direction related to corrective action plans and future reevaluation of performance. B. The department shall, with input from healthcare providers and in accordance with the Administrative Procedure Act, promulgate rules relative to appropriate and inappropriate determinations by recovery audit contractors, and to establish penalties and sanctions to be associated with inappropriate determinations by those contractors. C. If the department or the hearing officer in a formal appeal finds that the recovery audit contractor's determination was unreasonable, frivolous, or without merit, then the contractor shall reimburse to the provider the provider's costs associated with the appeals process. Acts 2014, No. 568, §1, eff. Aug. 15, 2014.
LA Rev Stat § 46:441 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§441. Surviving spouse of public assistance recipients; retention of benefits received during month of death

RS 441 - Surviving spouse of public assistance recipients; retention of benefits received during month of death  A surviving spouse of a general assistance recipient is hereby authorized to receive and retain any financial assistance paid by the Department of Children and Family Services to or for the benefit of said recipient during the month of the death of said recipient, whether or not the check covering such assistance was actually received prior to the death of the recipient.  Acts 1962, No. 97, §1. Amended by Acts 1974, No. 670, §1; Acts 1978, No. 786, §6, eff. July 17, 1978.
LA Rev Stat § 46:442 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§442. Medicaid provider claims; period for filing

RS 442 - Medicaid provider claims; period for filing  A. In administering the Medicaid program of this state, the Louisiana Department of Health shall not limit the period within which a healthcare provider may submit a claim for payment for a covered service rendered to a Medicaid program enrollee to less than three hundred sixty-five days from the date the service was provided.  B. In accordance with the applicable provisions of this Part and Part VI-A of this Chapter, if a payment for a claim is recouped by the department, a contractor of the department, or any other entity acting at the direction or under the authority of the department due to a determination by the department more than three hundred sixty-five days from the date the service was provided that the claim was improperly billed but the services were reasonable and necessary, the department shall ensure that the provider is afforded additional time to re-file a corrected claim for that portion of the amount recouped to the extent permitted by federal law.  Acts 2015, No. 21, §1; Acts 2016, No. 467, §1.
LA Rev Stat § 46:443 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§443. Exemption of income and resources

RS 443 - Exemption of income and resources  The secretary of the Department of Children and Family Services and the secretary of the Louisiana Department of Health are hereby authorized to adopt income and resources exemption policies to the extent necessary to conform with the federal Economic Opportunity Act, any social security provision, and any other laws of congress to obtain federal block grant or matching funds for the state's public assistance program. Such income and resources exemption policies shall prevail in the event they conflict with R.S. 46:151, 153, 154, and 233.  Added by Acts 1965, No. 19, §1. Amended by Acts 1978, No. 786, §6, eff. July 17, 1978; Acts 1997, No. 1155, §1, eff. July 1, 1997.
LA Rev Stat § 46:444 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§444. Cooperation with administrative agencies relative to interchange of information

RS 444 - Cooperation with administrative agencies relative to interchange of information  The Department of Children and Family Services is hereby authorized to provide for interchange of such information necessary in providing for work training experiences as required by Public Law 90-248, as the secretary of the United States Department of Health, Education and Welfare, or its successor department, may require for federal matching purposes.  Added by Acts 1968, No. 167, §1. Amended by Acts 1978, No. 786, §6, eff. July 17, 1978; Acts 2018, No. 206, §5.
LA Rev Stat § 46:445 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§445. Minor emancipated by marriage; nursing care benefits

RS 445 - Minor emancipated by marriage; nursing care benefits  A minor emancipated by marriage shall not be ineligible, by reason of age alone, to apply for and receive nursing care benefits.  Added by Acts 1970, No. 347, §1.
LA Rev Stat § 46:446.1 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§446.1. Notice to department by insurance companies; payment of assigned claims; civil penalties

RS 446.1 - Notice to department by insurance companies; payment of assigned claims; civil penalties  A.(1) Every person or entity authorized to issue a hospital or medical service contract or any insurance contract in the state of Louisiana, shall provide notice to the Louisiana Department of Health not later than thirty days prior to payment of any insurance claim, when such claim is clearly identified for services provided in a state facility or by a Medicaid provider pursuant to rules and regulations established by the secretary of the Louisiana Department of Health. Such notice is required so that the department may determine if any portion of such claims is duly payable to the state of Louisiana for services provided by the department to the insured and on whose behalf the state of Louisiana may be entitled to receive insurance benefits.  (2) Contracts subject to such notice provisions shall include but are not limited to employee welfare benefit plans, health and accident insurance policies, including liability and uninsured motorist provisions, group insurance plans, self insurance plans, and the Louisiana State Employees Uniform Group Benefits Program.  B. Information provided pursuant to Subsection A of this Section shall be confidential and subject to the provisions of R.S. 46:56.  C. Upon notification by the department that all or any portion of such claims reported is duly payable to the state or a Medicaid provider, or subject to an assignment of benefits under R.S. 46:153(E), or subject to recovery under R.S. 46:446, payment shall be made to the department or Medicaid provider and the insured notified that payment of the claims has been assigned by the state of Louisiana for services rendered in a state facility or by a Medicaid provider.  D. Any person or entity who fails to provide required notification and assignment of benefits for any claim pursuant to this Section shall be liable for payment to the Louisiana Department of Health for any amounts which would otherwise have been paid under assignment. In addition, such person or entity shall be subject to civil penalties of ten percent of the amounts so payable, such penalties not to exceed five hundred dollars.  E. The penalties assessed by R.S. 22:1821 for failure to make timely payment of benefits shall not apply if the delay in such payment occurs as a result of compliance with the provisions of this Section.  Acts 1988, No. 697, §1, eff. July 15, 1988; Acts 2008, No. 415, §2, eff. Jan. 1, 2009; Acts 2018, No. 206, §5.
LA Rev Stat § 46:446.2 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§446.2. Third-party liability; acquisition of rights

RS 446.2 - Third-party liability; acquisition of rights  A. For purposes of R.S. 46:446.2 through 446.5, "third party" shall mean health and accident insurers, group health plans as defined in §607(1) of the Employee Retirement Income Security Act of 1974, service benefit plans, hospital and medical service plans, health maintenance organizations, limited benefit health insurers, group blanket and franchise insurers, and state employee group benefits plan.  B. For purposes of R.S. 46:446.2 through 446.5, "department" shall mean the Louisiana Department of Health.  C. The state, through the department shall:  (1) Undertake all reasonable measures to ascertain the legal liability of third parties, including the collection of sufficient information to enable the department to pursue claims against such third parties. This information shall be collected at the time of any determination or redetermination of eligibility for Medicaid.  (2) Seek reimbursement for such assistance to the extent of such legal liability in any case where such a legal liability is found to exist after medical assistance has been made available on behalf of the individual and where the amount of reimbursement the department can reasonably expect to recover exceeds the cost of such recovery.  D. To the extent that payment for covered expenses has been made by Medicaid for health care items or services furnished to an individual, in any case where a third party has a legal liability to make payments, the state is deemed to have acquired the rights of the individual to payment by any other party for those health care items or services.  Acts 1995, No. 616, §1.
LA Rev Stat § 46:446.3 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§446.3. Prenatal or preventive pediatric care; payment and reimbursement

RS 446.3 - Prenatal or preventive pediatric care; payment and reimbursement In the case of prenatal or preventive pediatric care including early and periodic screening and diagnosis services paid by Medicaid, the department shall: (1) Make payment for such service in accordance with the usual payment schedule for such services without regard to the liability of a third party for payment for such services. (2) Seek reimbursement from such third party in accordance with R.S. 46:446.2(C)(2). Acts 1995, No. 616, §1.
LA Rev Stat § 46:446.4 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§446.4. Payment for dependent children; reimbursement

RS 446.4 - Payment for dependent children; reimbursement In the case of any services covered by Medicaid which are provided to an individual on whose behalf child support enforcement is being carried out by the state, the department shall: (1) Make payment for such service in accordance with the usual payment schedule under Medicaid for such services without regard to any third-party liability for payment for such services, if such third-party liability is derived through insurance or otherwise from the parent whose obligation to pay support is being enforced by such agency, if payment has not been made by such third party within thirty days after such services are furnished. (2) Seek reimbursement from such third party in accordance with R.S. 46:446.2(C)(2). Acts 1995, No. 616, §1.
LA Rev Stat § 46:446.5 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§446.5. Participating providers; furnishing of services; collection of fees

RS 446.5 - Participating providers; furnishing of services; collection of fees A. A person who furnishes services and is participating as a provider in the Medicaid program may not refuse to furnish services to an individual who is entitled to have payment made by Medicaid for the services the person furnishes because of a third party's potential liability for payment of the service. B. In the case of an individual who is entitled to Medicaid with respect to a service for which a third party is liable for payment, the person furnishing the service may not seek to collect from the individual or any financially responsible relative or representative for that individual payment of an amount for that service if: (1) The total of the amount of the liability of third parties for that service is at least equal to the amount payable for that service under Medicaid disregarding 42 U.S.C. 1396(o). (2) The amount which exceeds the lesser of the amount which may be collected under Medicaid pursuant to 42 U.S.C. 1396(o) or the amount by which the amount payable for that service under Medicaid disregarding 42 U.S.C. 1396(o) exceeds the total of the amount of the liabilities of third parties for that service. Acts 1995, No. 616, §1.
LA Rev Stat § 46:447 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§447. Revision of standard of need; aid to families with dependent children; general assistance

RS 447 - Revision of standard of need; aid to families with dependent children; general assistance   A. The Louisiana Department of Health and the Department of Children and Family Services jointly shall revise the standard of need for the Family Independence Temporary Assistance Program and the general assistance program each year, basing such standard on the Annual Update of the Poverty Income Guidelines published by the United States Department of Health and Human Services. The standard shall reflect the higher of the southern and national averages. The departments shall cause such revised standard to become effective on January first of each year.   B. Implementation of this provision shall be contingent on the Louisiana Department of Health and the Department of Children and Family Services certifying to the commissioner of the division of administration that the revision will not increase the total state dollar expenditure for the two departments.   Acts 1989, No. 722, §1.
LA Rev Stat § 46:447.3 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§447.3. In-hospital mental health care for adopted children; state's duty to furnish

RS 447.3 - In-hospital mental health care for adopted children; state's duty to furnish To the extent funds are appropriated by the legislature for such purpose, in all adoption subsidy agreements executed after September 1, 2001, involving a child in the custody of the Department of Children and Family Services, the state shall agree to provide acutely medically necessary in-hospital mental health treatment for that child until he reaches the age of majority, provided that the child is not eligible for, or has otherwise exhausted benefits under Medicaid, LaCHIP, or any contract of health and accident insurance or any health benefit plan. The burden of providing the appropriate documentation of the child's eligibility for medical benefits under this statute shall be upon the adoptive parents. Acts 2001, No. 981, §1.