reglab/housing_qa huggingface dataset:
LA Rev Stat § 46:460.74 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§460.74. Prior authorization; criteria; notice to providers

RS 460.74 - Prior authorization; criteria; notice to providers  A. The prior authorization requirements of the department and each managed care organization, including prior authorization requirements applicable in the Medicaid pharmacy program, shall either be furnished to the healthcare provider within twenty-four hours of a request for the requirements or posted in an easily searchable format on the website of the respective managed care organization or the department. Information posted in accordance with the requirements of this Section shall include the date of last review.  B. If the department or a managed care organization denies a prior authorization request, then the department or managed care organization shall provide written notice of the denial to the provider requesting the prior authorization within three business days of making the decision. If the denial of the prior authorization by the department or managed care organization is based upon an interpretation of a law, regulation, policy, procedure, or medical criteria or guideline, then the notice shall contain either instructions for accessing the applicable law, regulation, policy, procedure, or medical criteria or guideline in the public domain or an actual copy of that law, regulation, policy, procedure, or medical criteria or guideline.  Acts 2019, No. 330, §1.
LA Rev Stat § 46:460.77.1 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§460.77.1. Behavioral health services claims; limitation on service hours; information required for payment

RS 460.77.1 - Behavioral health services claims; limitation on service hours; information required for payment  A.(1) For purposes of this Section, "CPST services" means community psychiatric support and treatment services and "PSR services" means psychosocial rehabilitation services.  (2) An individual behavioral health services provider rendering CPST services, PSR services, or both shall be limited to a maximum combined total of twelve reimbursable hours of CPST services and PSR services per rendering provider, per calendar day, regardless of the number of patients seen by the rendering provider unless any of the following conditions are met:  (a) The medical necessity of the services is documented for a Medicaid recipient receiving more than twelve hours of CPST and PSR services per day per rendering provider.  (b) The services are billed for a group setting. However, the total hours worked by an individual rendering provider shall not exceed twelve reimbursable hours per calendar day.  (c) The services are billed for crisis intervention.  (3)(a) Services subject to the twelve-hour limitation provided in Paragraph (2) of this Subsection include only CPST and PSR services rendered per individual National Provider Identifier at one or more outpatient behavioral health services provider facilities or agencies within a calendar day.  (b) The twelve-hour limitation provided in Paragraph (2) of this Subsection shall not apply per individual behavioral health services provider agency.  (4)(a) Except as provided in Subparagraph (b) of this Paragraph, the provisions of this Subsection shall apply exclusively to CPST services and PSR services.  (b) The provisions of this Subsection shall not apply to evidence-based practices including, without limitation, the practices known as assertive community treatment, multisystemic therapy, functional therapy, and homebuilders.  B. No managed care organization shall accept for payment a claim from a provider of behavioral health services unless that claim includes all claim information required by R.S. 40:2162.  C. The department shall include the limitation on reimbursable hours of CPST and PSR services provided in Subsection A of this Section in each contract with a managed care organization that covers behavioral health services.  D. Implementation of any provision of this Section shall be subject to approval by the Centers for Medicare and Medicaid Services.  Acts 2019, No. 370, §1.
LA Rev Stat § 46:460.77.2 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§460.77.2. Behavioral health services claim information; access by legislative auditor and Medicaid Fraud Control Unit

RS 460.77.2 - Behavioral health services claim information; access by legislative auditor and Medicaid Fraud Control Unit  Upon request of the legislative auditor or the Medicaid Fraud Control Unit of the office of the attorney general, the department shall furnish to the requestor behavioral health data that meets the applicable standard for completeness set forth by the Centers for Medicare and Medicaid Services.  Acts 2019, No. 370, §1.
LA Rev Stat § 46:460.77.3 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§460.77.3. Staff training requirements

RS 460.77.3 - Staff training requirements  A. Employees, contractors, and subcontractors of managed care organizations performing work or services related to the performance or supervision of audits, prior authorization determinations, and clinical reviews of mental health rehabilitation services providers shall receive annual training on Louisiana's Medicaid Behavioral Health Provider Manual and the relevant state laws, policies, and regulations related to the state's mental health rehabilitation program.  B. Employees, contractors, and subcontractors of managed care organizations shall take all necessary steps to ensure mental health rehabilitation services providers are rostered, credentialed, or otherwise eligible to provide and be reimbursed for mental health rehabilitation services in accordance with R.S. 46:460.61.  C. For purposes of this Section, the following definitions apply:  (1) "Mental health rehabilitation" means an outpatient healthcare program provider of any psychosocial rehabilitation, crisis intervention, or community psychiatric support and treatment services that promotes the restoration of community functioning and well-being of an individual diagnosed with a mental health or mental or emotional disorder. A mental health rehabilitation provider uses evidence-based supports and interventions designed to improve individual and community outcomes.  (2) "Mental health rehabilitation services" means outpatient services for adults with serious mental illness and children with emotional or behavioral disorders which are medically necessary to reduce the disability resulting from mental illness and assist in the recovery and resiliency of the recipient. Such services are home- and community-based and are provided on an as-needed basis to assist recipients in coping with the symptoms of their illness. The intent of mental health rehabilitation services is to minimize the disabling effects on the individual's capacity for independent living and to prevent or limit the periods of inpatient treatment.  D. The department shall promulgate in accordance with the Administrative Procedure Act all rules as are necessary to implement the provisions of this Section.  Acts 2021, No. 204, §2, eff. Jan. 1, 2022.
LA Rev Stat § 46:460.81 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§460.81. Right of providers to independent review; applicability

RS 460.81 - Right of providers to independent review; applicability  A. If a provider's claim is subject to an adverse determination evidenced in a remittance advice or other written or electronic notice from a managed care organization, then the provider shall have a right to an independent review of the adverse action taken by the managed care organization. Such independent review shall be governed by the provisions of this Subpart and any applicable rules and regulations promulgated by the department pursuant to the Administrative Procedure Act. The provisions of this Subpart shall not otherwise prohibit or limit any alternative legal or contractual remedy available to a provider to contest the partial or total denial of a claim for payment for healthcare services. Any contractual provision executed between a provider and a managed care organization which seeks to limit or otherwise impede the appeal process as set forth in this Subpart shall be null, void, and deemed to be contrary to the public policy of this state.  B. The provisions of this Subpart shall not apply to any adverse determination associated with a claim filed with a managed care organization prior to January 1, 2018, regardless of whether the claim is re-filed after that date. For all adverse determinations related to claims filed on or after January 1, 2018, the state shall not mandate that the provider and managed care organization resolve the claim payment dispute through arbitration.  C. An adverse determination involved in litigation or arbitration or not associated with a Medicaid enrollee shall not be eligible for independent review under the provisions of this Subpart. NOTE: Subsection (D) as enacted by Acts 2021, No. 204, eff. Jan. 1, 2022.  D. Notwithstanding any other provision of law, a mental health rehabilitation services provider shall have the right to an independent review of an adverse determination taken by a managed care organization that results in a recoupment of the payment of a claim based upon a finding of waste or abuse.  Acts 2017, No. 349, §2; Acts 2021, No. 204, §2, eff. Jan. 1, 2022.
LA Rev Stat § 46:460.83 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§460.83. Independent review; judicial appeal

RS 460.83 - Independent review; judicial appeal  Within sixty calendar days of an independent reviewer's decision, either party to the dispute may file suit in any court having jurisdiction to review the independent reviewer's decision and to recover any funds awarded by the independent reviewer to the other party. Any claim concerning an independent reviewer's decision not brought within sixty calendar days of the decision shall be barred indefinitely. Suits filed pursuant to this Section shall be conducted in accordance with applicable provisions of the Code of Civil Procedure, and the review by the court will be de novo without regard to the independent reviewer's decision. The independent reviewer and any person who assisted the independent reviewer in reaching a decision shall be prohibited from testifying at the court proceeding considering the independent reviewer's decision. Venue shall be proper in the district court for the parish where either the healthcare provider or the managed care organization is domiciled, and the district court for that parish has exclusive jurisdiction thereof. If the dispute between the parties is not fully resolved prior to the entry of a final decision by the court initially hearing the dispute, then the prevailing party shall be entitled to an award of reasonable attorney fees and expenses from the nonprevailing party. For purposes of this Section, "reasonable attorney fees" means the number of hours reasonably expended on the dispute multiplied by a reasonable hourly rate, and shall not exceed ten percent of the total monetary amount in dispute or five hundred dollars, whichever amount is greater.  Acts 2017, No. 349, §2.
LA Rev Stat § 46:460.84 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§460.84. Costs

RS 460.84 - Costs  A. The fee for conducting an independent review shall be paid to the independent reviewer by the managed care organization; except that for reviews conducted in accordance with R.S. 46:460.90, a dental coordinated care network shall pay the fee for an independent review to the Louisiana State University School of Dentistry. A provider shall, within ten days of the date of the decision of the independent reviewer, reimburse a managed care organization for the fee associated with conducting an independent review when the decision of the managed care organization is upheld. If the provider fails to submit payment for the independent review within ten days from the date of the decision, the managed care organization may withhold future payments to the provider in an amount equal to the cost of the independent review; however, the managed care organization shall ensure that such a withholding is clearly delineated on the remittance advice. If a provider fails to properly reimburse the managed care organization, the department may prohibit that provider from future participation in the independent review process.  B. The managed care organization shall compensate the independent reviewer within thirty calendar days of receipt by the managed care organization of the reviewer's bill for services rendered. If the managed care organization fails to pay the bill for the independent reviewer's services, then the reviewer may request payment directly from the department from any funds held by the state that are payable to the managed care organization.  C. The fee for an independent review of a dental claim conducted in accordance with R.S. 46:460.90 shall be paid in an amount established in a contract or memorandum of understanding between the department and the Louisiana State University School of Dentistry.  Acts 2017, No. 349, §2; Acts 2018, No. 284, §1.
LA Rev Stat § 46:460.85 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§460.85. Independent reviewer selection panel; procedure

RS 460.85 - Independent reviewer selection panel; procedure  A. The Independent Reviewer Selection Panel is hereby created within the department. The duties of the panel shall pertain to the independent review of claims except those reviewed in accordance with R.S. 46:460.90. The panel shall consist of the secretary or his duly designated representative and the following members appointed by the secretary:  (1) Two provider representatives.  (2) Two managed care organization representatives.  B. All decisions of the panel shall be made by a majority vote. The panel shall meet at least twice per year. Panel members shall serve without compensation.  C. The panel shall:  (1) Select a chairperson.  (2) Select and identify an appropriate number of independent reviewers and determine a uniform rate of compensation per review to be paid to each reviewer.  (3) Continually review the number and outcome of requests for reconsideration and independent reviews on an aggregated basis. The panel shall not be provided any patient-identifying information for any reason.  D. The secretary shall report to the panel the name of any provider who submits ten or more requests for independent review along with the percentage of adverse determinations that are overturned.  Acts 2017, No. 349, §2; Acts 2018, No. 284, §1.
LA Rev Stat § 46:460.86 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§460.86. Independent reviewers

RS 460.86 - Independent reviewers  Each managed care organization shall utilize only independent reviewers who are selected in accordance with R.S. 46:460.85, and shall comply with the provisions of this Subpart in the resolution of disputed adverse determinations.  Acts 2017, No. 349, §2.
LA Rev Stat § 46:460.87 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§460.87. Penalties

RS 460.87 - Penalties  A managed care organization found by the secretary to be in violation of any provision of this Subpart may be subject to a penalty of up to twenty-five thousand dollars per violation. In addition, if a managed care organization is subject to more than one hundred independent reviews annually and the percentage of adverse determinations overturned in favor of the healthcare provider as a result of an independent review is greater than twenty-five percent, the managed care organization may be subject to a penalty of up to twenty-five thousand dollars.  Acts 2017, No. 349, §2.
LA Rev Stat § 46:460.88 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§460.88. Rules and regulations

RS 460.88 - Rules and regulations  The department shall promulgate all rules and regulations in accordance with the Administrative Procedure Act as may be necessary to effectuate and implement the provisions of this Subpart.  Acts 2017, No. 349, §2.
LA Rev Stat § 46:460.89 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§460.89. Repealed by Acts 2018, No. 284, §2.

RS 460.89 - Repealed by Acts 2018, No. 284, §2.
LA Rev Stat § 46:461 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§461. Infirm, sick and disabled paupers

RS 461 - Infirm, sick and disabled paupers  Parish governing authorities shall provide for the support of all infirm, sick and disabled paupers residing within the limits of their respective parishes except those who may reside in municipal corporations either exempt or partially exempt from parish taxation. Parish governing authorities shall adopt such measures as they deem just and necessary to ascertain the names, situation and condition of all infirm, sick and disabled paupers in order that they may provide for the entire support of the utterly destitute and helpless and for the partial support or assistance of others, according to their circumstances and condition.
LA Rev Stat § 46:462 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§462. Farm or home may be provided

RS 462 - Farm or home may be provided  Parish governing authorities may buy or lease a farm or other home for the infirm, sick and disabled paupers residing within their respective parishes, and may make such arrangements and appoint such officials and agents, with such compensation as they may deem necessary for the proper management thereof and to make the farm or home wholly or in part self-sustaining.
LA Rev Stat § 46:463 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§463. Farms or manufactories recognized as public works

RS 463 - Farms or manufactories recognized as public works  If parish governing authorities shall establish any farms or manufactories, or embark in any farming or manufacturing enterprises, to carry out the object of this Part, they shall be regarded and recognized as public works within the meaning of the law.
LA Rev Stat § 46:464 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§464. Persons eligible

RS 464 - Persons eligible  No parish or parish official shall, at the public expense, support or aid any persons as paupers, except such as are infirm, sick or disabled.
LA Rev Stat § 46:465 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§465. Pauper fund appropriations

RS 465 - Pauper fund appropriations  A. The amount to be appropriated as a pauper fund to carry out any and all purposes of this Part, or under any and all other laws on the subject, shall be included in the estimate required to be made by parishes in estimating the taxes and expenditures for the purpose of fixing the amount of taxes to be assessed for the current year, as provided by law.  B. No debt shall be created against the parish beyond the amount appropriated and collected for the purpose with other current parish taxes.  Acts 2018, No. 206, §5.
LA Rev Stat § 46:501 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§501. Alms fund in certain parishes and cities

RS 501 - Alms fund in certain parishes and cities  For the creation of an "alms fund" to care and provide for the poor, indigent and destitute persons of the parishes and cities, the governing authorities of those parishes of the state which contain a city of not less than twenty-five thousand nor more than one hundred thousand inhabitants, shall set aside ten percent of all fines and forfeitures of bonds in criminal cases collected by the district court for violations of the laws of the state and parish, while holding sessions in the parish. The cities having a population of not less than twenty-five thousand nor more than one hundred thousand inhabitants shall likewise set aside ten percent of all fines and forfeitures of bonds given in criminal cases, collected in and by the municipal court, which fines have been assessed for the infractions of municipal ordinances.
LA Rev Stat § 46:502 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§502. Parish governing authority to manage parish funds

RS 502 - Parish governing authority to manage parish funds  The parish governing authority of the parish shall have the control and management of the funds set apart by the parish governing authorities in accordance with this Part.
LA Rev Stat § 46:503 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§503. City council to manage city funds

RS 503 - City council to manage city funds  The city council of the cities shall have the control and management of the funds set apart as provided by this Part.
LA Rev Stat § 46:504 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§504. Investment of funds

RS 504 - Investment of funds  The governing authority of the parish or city councils of the cities may draw from its treasury the sum to invest it for the account of the "alms fund", in interest bearing bonds of the United States, of the State of Louisiana, and of the bonds paving certificates or approved obligations of the parish or cities having control of the funds.
LA Rev Stat § 46:505 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§505. Fund not to exceed twenty five thousand dollars; yearly revenue to be expended

RS 505 - Fund not to exceed twenty five thousand dollars; yearly revenue to be expended  After the fund set apart by the parish reaches twenty-five thousand dollars, and the fund set apart by the cities reaches twenty-five thousand dollars, the parish and cities shall thereafter no longer continue to set aside the pro rata part of the fines provided for in this Part, but the funds of twenty-five thousand dollars respectively shall be invested as set forth in this Part, and only the yearly interest or revenue shall be expended in carrying out the purpose of this Part.
LA Rev Stat § 46:506 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§506. Receipt of funds for benefit of alms fund; twenty five thousand dollars to be permanent fund

RS 506 - Receipt of funds for benefit of alms fund; twenty five thousand dollars to be permanent fund  The governing authority or the city council of the respective parish or city may at any time receive funds or property of any character for the benefit of the alms fund; provided that the sum of twenty-five thousand dollars, which may be received and accumulated, from whatever sources, shall be retained as a permanent fund, the annual income alone being available for the use and purposes set forth in this Part.
LA Rev Stat § 46:507 (2021)
2021 Louisiana Laws|Revised Statutes|Title 46 - Public Welfare and Assistance|§507. Surplus revenue, transfers between parish and city

RS 507 - Surplus revenue, transfers between parish and city  The governing authority of the parish, and the city council of the city, may first use or expend the income from the fund so provided for the poor, indigent and destitute of its particular jurisdiction, but in the event all of the annual revenue of the parish arising from the alms fund provided by this Part is not needed in the parish outside of the city, then, if the surplus is needed by the city for its poor, indigent and destitute, the parish shall pay over to the alms fund of the city that portion of its yearly revenue not needed by it during that year, and likewise if the city does not expend all of the revenues during any one year arising from its alms fund provided by this Part, it shall pay over the surplus left over from the year to the alms fund of the parish, if the poor, indigent and destitute of the parish stand in need thereof.