§ 40:2204 — Hospital participation; tangible benefit presumed

§2204. Hospital participation; tangible benefit presumed
A. Whenever any hospital or governmental body is a party to a preferred provider
organization contract, there shall be a rebuttable presumption that such hospital or
governmental body contracted with the expectation of receiving a tangible benefit rather than
making a donation of services in violation of Section 14(A) of Article VII of the Constitution
of Louisiana.
B. Unless clearly indicated otherwise in a preferred provider organization contractual
arrangement, it shall be presumed that the hospital, governmental body, or other provider
negotiated the contract with the knowledge that such agreement would result in a tangible
benefit to the hospital or governmental body and would not constitute a donation of its
services to a group purchaser in violation of the Constitution of Louisiana, Article VII,
Section 14(A).
C. Whenever a hospital or governmental body is a party to a preferred provider
organization contract, the provisions of R.S. 39:1481 et seq. shall not apply.
D.(1) The state, or any agency of the state authorized by law to contract with or
develop preferred provider organizations or other managed health care arrangements,
including the Office of Group Benefits, when interested in developing or participating in a
preferred provider organization or other managed care arrangement, shall develop criteria
governing the state's or the agency's contracting with health care providers or with preferred
provider organizations or other managed care arrangements. All such criteria shall be
approved by the appropriate standing committees of the legislature having jurisdiction over
review of that agency's rules, or the subcommittees on oversight of such standing
committees, and the office of state procurement of the division of administration.
(2) Each agency authorized by law to develop or contract with preferred provider
organizations or other managed care arrangements shall promulgate rules and regulations to
establish a process through which notice of intent to contract with health care providers,
preferred provider organizations, or other managed care arrangements is given. The rules
and regulations shall contain provisions requiring written or published notice of the agency's
intent to seek contracts for the requested services and the availability, upon request, of a
detailed explanation of the services sought and of the criteria that are to be used in
developing contracts. There shall be a written public announcement of the contractor or
contractors awarded the contract. Upon request, any entity submitting a proposal which is
not accepted shall be furnished a written explanation for the agency's action. Any contract
executed in violation of rules and regulations promulgated under this Subsection shall be
void.
(3) All contracts shall be approved by the chief executive officer in the Office of
Group Benefits.
(4) The provisions of this Section shall not be applicable to the Louisiana
Department of Health.

Legislative History

Added by Acts 1984, No. 374, §1, eff. July 6, 1984. Amended by Acts 1990, No. 585, §1, eff. July 19, 1990; Acts 1992, No. 864, §1; Acts 1993, No. 783, §1; Acts 2001, No. 1178, §4, eff. June 29, 2001; Acts 2014, No. 864, §§4 and 5.