Louisiana Revised Statutes > Title 46 > Chapter 3 > Part VI-A > Subpart A – General Provisions
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Terms Used In Louisiana Revised Statutes > Title 46 > Chapter 3 > Part VI-A > Subpart A - General Provisions
- Administrative adjudication: means adjudication and the adjudication process contained in the Administrative Procedure Act. See Louisiana Revised Statutes 46:437.3
- Agent: means a person who is employed by or has a contractual relationship with a health care provider or who acts on behalf of the health care provider. See Louisiana Revised Statutes 46:437.3
- Billing agent: means an agent who performs any or all of the health care provider's billing functions. See Louisiana Revised Statutes 46:437.3
- Claim: means any request or demand, whether under a contract or otherwise, for money or property, whether or not the state or department has title to the money or property, that is drawn in whole or in part on medical assistance programs funds that are either of the following:
(a) Presented to an officer, employee, or agent of the state or department. See Louisiana Revised Statutes 46:437.3
- Commission: means the Louisiana Wildlife and Fisheries Commission. See Louisiana Revised Statutes 34:851.2
- 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.
- Department: means the Louisiana Department of Health. See Louisiana Revised Statutes 46:437.3
- Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
- Dismissal: The dropping of a case by the judge without further consideration or hearing. Source:
- Embezzlement: In most states, embezzlement is defined as theft/larceny of assets (money or property) by a person in a position of trust or responsibility over those assets. Embezzlement typically occurs in the employment and corporate settings. Source: OCC
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Fiduciary: A trustee, executor, or administrator.
- Fraud: Intentional deception resulting in injury to another.
- Grantor: The person who establishes a trust and places property into it.
- Health care provider: means any person furnishing or claiming to furnish a good, service, or supply under the medical assistance programs, any other person defined as a health care provider by federal or state law or by rule, and a provider-in-fact. See Louisiana Revised Statutes 46:437.3
- Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
- 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.
- Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC
- Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
- Managing employee: means a person who exercises operational or managerial control over, or who directly or indirectly conducts, the day-to-day operations of a health care provider. See Louisiana Revised Statutes 46:437.3
- Material: means having a natural tendency to influence, or be capable of influencing, the payment or receipt of money or property. See Louisiana Revised Statutes 46:437.3
- Medical assistance programs: means the Medical Assistance Program (Title XIX of the Social Security Act), commonly referred to as "Medicaid" and other programs operated by and funded in the department which provide payment to health care providers. See Louisiana Revised Statutes 46:437.3
- Misrepresentation: means the knowing failure to truthfully or fully disclose any and all information required, or the concealment of any and all information required on a claim or a provider agreement or the making of a false or misleading statement to the department relative to the medical assistance programs. See Louisiana Revised Statutes 46:437.3
- Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
- Motorboat: means any vessel equipped with or propelled by any type of machinery whether or not such machinery is the principal source of propulsion but shall not include a vessel which has a valid marine document issued by the Bureau of Customs of the United States Government or any federal agency successor thereto, unless the vessel is a recreational use vessel. See Louisiana Revised Statutes 34:851.2
- Obligation: means an established duty, whether or not fixed, arising from an express or implied contractual, grantor, grantee, or licensor-licensee relationship, from a free-based or similar relationship, from statute or regulation, or from the retention of any overpayment. See Louisiana Revised Statutes 46:437.3
- Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
- Operate: means to navigate or otherwise use a motorboat or vessel. See Louisiana Revised Statutes 34:851.2
- Order: means a final order imposed pursuant to an administrative adjudication. See Louisiana Revised Statutes 46:437.3
- Oversight: Committee review of the activities of a Federal agency or program.
- Owner: means a person, other than a lien holder, having a property interest in or title to a motorboat. See Louisiana Revised Statutes 34:851.2
- Ownership interest: means the possession, directly or indirectly, of equity in the capital or the stock, or the right to share in the profits, of a health care provider. See Louisiana Revised Statutes 46:437.3
- Payment: means the payment to a health care provider from medical assistance programs funds pursuant to a claim, or the attempt to seek payment for a claim. See Louisiana Revised Statutes 46:437.3
- person: includes a body of persons, whether incorporated or not. See Louisiana Revised Statutes 1:10
- Person: means an individual, partnership, firm, corporation, association, or other entity. See Louisiana Revised Statutes 34:851.2
- Prohibited zone: means an area paralleling each side of the entire length of the Lake Pontchartrain Causeway Bridge and extending outward for a distance of one mile from both the most easterly and westerly outboard sides of the causeway bridge twin spans. See Louisiana Revised Statutes 34:851.2
- Property: means any and all property, movable and immovable, corporeal and incorporeal. See Louisiana Revised Statutes 46:437.3
- Provider agreement: means a document which is required as a condition of enrollment or participation as a health care provider under the medical assistance programs. See Louisiana Revised Statutes 46:437.3
- Provider-in-fact: means an agent who directly or indirectly participates in management decisions, has an ownership interest in the health care provider, or other persons defined as a provider-in-fact by federal or state law or by rule. See Louisiana Revised Statutes 46:437.3
- Recipient: means an individual who is eligible to receive health care through the medical assistance programs. See Louisiana Revised Statutes 46:437.3
- Recoupment: means recovery through the reduction, in whole or in part, of payment to a health care provider. See Louisiana Revised Statutes 46:437.3
- Recovery: means the recovery of overpayments, damages, fines, penalties, costs, expenses, restitution, attorney fees, or interest or settlement amounts. See Louisiana Revised Statutes 46:437.3
- Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
- Rule: means any rule or regulation promulgated by the department in accordance with the Administrative Procedure Act and any federal rule or regulation promulgated by the federal government in accordance with federal law. See Louisiana Revised Statutes 46:437.3
- Sanction: shall include but is not limited to any or all of the following:
(a) Recoupment. See Louisiana Revised Statutes 46:437.3
- Secretary: means the secretary of the Department of Wildlife and Fisheries. See Louisiana Revised Statutes 34:851.2
- Secretary: means the secretary of the Louisiana Department of Health, or his authorized designee. See Louisiana Revised Statutes 46:437.3
- Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
- Statute: A law passed by a legislature.
- Temporary restraining order: Prohibits a person from an action that is likely to cause irreparable harm. This differs from an injunction in that it may be granted immediately, without notice to the opposing party, and without a hearing. It is intended to last only until a hearing can be held.
- Vessel: means watercraft and air boats of every description, other than a seaplane on the water, used or capable of being used as a means of transportation on water. See Louisiana Revised Statutes 34:851.2
- Watercraft: means any contrivance used or designated for navigation on water. See Louisiana Revised Statutes 34:851.2
- Waters of the state: means any waters within the territorial limits of this state and the marginal sea adjacent to this state and the high seas when navigated as a part of a journey or ride to or from the shore of this state. See Louisiana Revised Statutes 34:851.2
- Withhold payment: means to reduce or adjust the amount, in whole or in part, to be paid to a health care provider for a pending or future claim during the time of a criminal, civil, or departmental investigation or proceeding or claims review of the health care provider. See Louisiana Revised Statutes 46:437.3