RS 446.1 - Notice to department by insurance companies; payment of assigned claims; civil penalties
A.(1) Every person or entity authorized to issue a hospital or medical service contract or any insurance contract in the state of Louisiana, shall provide notice to the Louisiana Department of Health not later than thirty days prior to payment of any insurance claim, when such claim is clearly identified for services provided in a state facility or by a Medicaid provider pursuant to rules and regulations established by the secretary of the Louisiana Department of Health. Such notice is required so that the department may determine if any portion of such claims is duly payable to the state of Louisiana for services provided by the department to the insured and on whose behalf the state of Louisiana may be entitled to receive insurance benefits.
(2) Contracts subject to such notice provisions shall include but are not limited to employee welfare benefit plans, health and accident insurance policies, including liability and uninsured motorist provisions, group insurance plans, self insurance plans, and the Louisiana State Employees Uniform Group Benefits Program.
B. Information provided pursuant to Subsection A of this Section shall be confidential and subject to the provisions of R.S. 46:56.
C. Upon notification by the department that all or any portion of such claims reported is duly payable to the state or a Medicaid provider, or subject to an assignment of benefits under R.S. 46:153(E), or subject to recovery under R.S. 46:446, payment shall be made to the department or Medicaid provider and the insured notified that payment of the claims has been assigned by the state of Louisiana for services rendered in a state facility or by a Medicaid provider.
D. Any person or entity who fails to provide required notification and assignment of benefits for any claim pursuant to this Section shall be liable for payment to the Louisiana Department of Health for any amounts which would otherwise have been paid under assignment. In addition, such person or entity shall be subject to civil penalties of ten percent of the amounts so payable, such penalties not to exceed five hundred dollars.
E. The penalties assessed by R.S. 22:1821 for failure to make timely payment of benefits shall not apply if the delay in such payment occurs as a result of compliance with the provisions of this Section.
Acts 1988, No. 697, §1, eff. July 15, 1988; Acts 2008, No. 415, §2, eff. Jan. 1, 2009; Acts 2018, No. 206, §5.