§ 46:440.12 — Definitions

Louisiana § 46:440.12

• Jurisdiction: Louisiana
• Title 46: Public Welfare and Assistance

Text

§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.

Legislative History

Acts 2014, No. 568, §1, eff. Aug. 15, 2014.