§ 40:2201 Legislative considerations
§ 40:2202 Definitions
§ 40:2203 Authorization for preferred provider organizations
§ 40:2203.1 Prohibition of certain practices by preferred provider organizations
§ 40:2204 Hospital participation; tangible benefit presumed
§ 40:2205 Utilization reviews; relief from liability and discovery; standards compliance
§ 40:2206 Obstetrician or gynecological examination; coverage
§ 40:2207 Requirements of provider contracts
§ 40:2208 Interpreter services for the deaf and hard of hearing; expenses; coverage
§ 40:2210 Prohibited discrimination; prenatal test results; genetic information

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Terms Used In Louisiana Revised Statutes > Title 40 > Chapter 12 > Part I - Preferred Provider Organizations

  • Alternative rates of payment: shall mean the rate at which or sum for which the provider agrees to perform specified services. See Louisiana Revised Statutes 40:2202
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
  • Governmental body: means any department, commission, council, board, office, bureau, committee, institution, agency, government, corporation, or establishment of the executive branch of this state. See Louisiana Revised Statutes 40:2202
  • Group purchaser: shall mean an organization or entity which contracts with providers for the purpose of establishing a preferred provider organization. See Louisiana Revised Statutes 40:2202
  • Hospital: shall mean any institution, place, building, or agency, public or private, whether for profit or not, including a facility subject to the jurisdiction of a hospital service district, devoted primarily to the maintenance and operation of facilities for ten or more individuals for the diagnosis, treatment, or care of persons admitted for overnight stay or longer who are suffering from illness, injury, infirmity, deformity, or other physical condition for which obstetrical, medical, or surgical services would be available and appropriate. See Louisiana Revised Statutes 40:2202
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Oversight: Committee review of the activities of a Federal agency or program.
  • person: includes a body of persons, whether incorporated or not. See Louisiana Revised Statutes 1:10
  • Provider: shall mean one or more entities which offer health care services and shall include but not be limited to hospitals, individuals, or groups of physicians, individuals or groups of psychologists, nurse midwives, ambulance service companies, and other health care entities. See Louisiana Revised Statutes 40:2202
  • Tangible benefit: shall mean but not be limited to:

                (a) Any reasonable expectation of a demonstrable increase in or maintenance of usage of the provider's services. See Louisiana Revised Statutes 40:2202

  • Testify: Answer questions in court.