Louisiana Administrative Code › Title 46 - PROFESSIONAL AND OCCUPATIONAL STANDARDS › Part LIV - Physical Therapy Examiners › Subpart 2 - Practice › Chapter 3 - Practice › Subchapter D - Disciplinary Proceedings › Section LIV-369 - Disclosure of Financial Interest and Abuse of Referrals [Formerly Section 327]

Current through Register Vol. 50, No. 6, June 20, 2024
A. Declaration
					 of Purpose; Interpretation and Application. Physical therapists and physical
					 therapist assistants owe a fiduciary duty to patients to exercise their
					 professional judgment in the best interests of their patients in providing,
					 furnishing, recommending, or referring patients for health care items and
					 services, without regard to personal financial recompense. The purpose of these
					 rules and the laws they implement is to prevent payments by or to a health care
					 provider as a financial incentive for the referral of a patients to a health
					 care provider for diagnostic or therapeutic services or items. These rules
					 shall be interpreted, construed and applied so as to give effect to such
					 purposes and intent.
B. As used in
					 R.S. 2420 A.(8) of the Practice Act, the phrase "engages directly or indirectly
					 in the division, transferring, assigning, rebating, or refunding of fees
					 received for professional service with a referring practitioner or any relative
					 or business associate of that referring practitioner" means the exploitation of
					 the physical therapy referral mechanism so that a referring practitioner
					 receives compensation, payment, or anything of value, including but not limited
					 to rental fees in excess of fair market value, or any other unearned monies or
					 value in kind, in return for a patient referral when the referring practitioner
					 does not have an ownership interest in the physical therapy practice
					 involved.
C. Violation of
					 R.S.
					 37:1744 shall be a violation of these rule
					 and the laws they implement.
D.
					 Violation of
					 R.S.
					 37:1745 shall be a violation of these rules
					 and the laws they implement.
E.
					 General Exceptions. Any payment, remuneration, practice, or arrangement, which
					 is not prohibited by or unlawful under §1128B(b) of the federal Social Security
					 Act (Act),
					 42
					 U.S.C. §
												1320a-7b(b), as
					 amended, with respect to health care items or services for which payment may be
					 made under title XVIII or title XIX of the Act, including those payments and
					 practices sanctioned by the secretary of the United States Department of Health
					 and Human Services, through the Office of the Inspector General, pursuant to
					 §1128B(b)(3)(E) of the Act, through regulations promulgated at
					 42
					 CFR §
												1001.952, as the same may hereafter be
					 amended, shall not be deemed a payment prohibited by
					 R.S.
					 37:1745(B) or by §369 of
					 these rules with respect to health care items or services for which payment may
					 be made by any patient, private, or governmental payer.
F. Sanctions. Upon proof of a violation, the
					 board may suspend or revoke, refuse to issue, or impose probationary or other
					 restrictions on any license and shall order the refund of all such sums
					 received in payment for the goods and services furnished or rendered without
					 disclosure of financial interest. Such a refund shall be paid to the individual
					 patient, third-party payor, or other entity who made the payment.
G. The board shall submit to the commissioner
					 of insurance an annual report listing the investigations undertaken pursuant to
					 this Section, including the number of violations and the sanctions imposed, if
					 any.
AUTHORITY NOTE:
						Promulgated in accordance with
						R.S.
						37:2405(A) and Act 535 of
						2009.