HB 560: MEDICAID: Provides relative to the Medical Assistance Programs Integrity Act (EN SEE FISC NOTE GF RV) - Louisiana

HB560 Original → HB560 Act · 5 edits

MODERATE

The bill was finalized into an Act, removing the original prefiling language and updating the summary of provisions to reflect the final text. Substantive changes include adding a new definition for 'Managed care organization' to clarify that it covers entities managing benefits under a capitated rate, and expanding the requirements for fraud settlements to ensure they cover estimated losses. The Act also clarifies that qui tam plaintiffs retain their rights to pursue actions under Subpart C regardless of other settlement provisions.

Scope change

The bill's scope was slightly expanded by adding a specific definition for 'Managed care organization' and clarifying that qui tam rights are preserved even when settlements are reached.

DEFINITION

Added a specific definition for 'Managed care organization' to include any entity contracted to manage healthcare benefits under a capitated rate.

Updated the definition of 'Managed care organization' to explicitly state that the entity provides 'provision or management' of benefits, broadening the scope from just 'management'.

REQUIREMENT

Added a requirement that fraud settlements must ensure recovery covers the estimated loss sustained by the medical assistance programs.

ENFORCEMENT

Clarified that nothing in the settlement section limits the rights of qui tam plaintiffs to bring actions in accordance with Subpart C.

TECHNICAL

Removed the original prefiling language and updated the bill header to reflect its status as an Enrolled Act.

HB560 Enrolled → HB560 Original · 5 edits

MODERATE

The bill was renumbered from an enrolled version to an original prefiling draft, shifting the document header from 'ENROLLED' to 'HLS 25RS-333 ORIGINAL'. Substantive legal text was significantly reorganized and corrected, including the removal of repealed statutes and the renaming of the law from 'Medical Assistance Programs Integrity Law' to 'Medical Assistance Programs Integrity Act'.

Scope change

The bill's scope remains focused on Medicaid fraud investigation and qui tam actions, but the specific statutes being amended and repealed were corrected to remove redundant or erroneous references found in the enrolled version.

TECHNICAL

The document header was changed from 'ENROLLED' to 'HLS 25RS-333 ORIGINAL', indicating this is a draft version for review rather than a finalized law.

The official title of the law was updated from 'Medical Assistance Programs Integrity Law' to 'Medical Assistance Programs Integrity Act' to align with current statutory naming conventions.

SCOPE

The list of statutes to be repealed was corrected by removing redundant references and adding a new repeal for R.S. 46:438.6(A)(2), ensuring only the intended laws are removed.

DEFINITION

Minor grammatical adjustments were made to the definition of 'Managed care organization' to improve clarity regarding the provision of healthcare benefits.

ENFORCEMENT

The text regarding qui tam plaintiff rights was restructured and corrected to ensure the legal protections for whistleblowers are clearly stated without redundancy.

HB560 Reengrossed → HB560 Enrolled · 4 edits · Jun 8, 2025

MODERATE

The bill was finalized as 'Enrolled' and shortened from 17 to 13 pages by removing preliminary filing information. Substantively, the law now requires settlements to include specific payment methods and security for the full amount, while adding protections for private qui tam plaintiffs. Additionally, the authority to file civil actions was expanded to include the Secretary of Health and Hospitals, and new criteria were added to allow defendants to recover legal fees if the state's action was deemed frivolous or harassing.

Scope change

The bill's scope was narrowed by removing the 'Medical Assistance Programs Integrity Act' title and pre-filing constitutional language, but its enforcement scope was broadened by adding the Secretary of Health and Hospitals as an authorized party to file civil actions.

REQUIREMENT

Settlements must now explicitly include the method of payment and adequate security for the full recovery amount.

ENFORCEMENT

The Secretary of Health and Hospitals is now authorized to institute civil actions alongside the Attorney General.

Defendants can recover legal fees if the state's action is found to be frivolous, vexatious, or brought for harassment.

TECHNICAL

Preliminary filing references and the 'Medical Assistance Programs Integrity Act' title were removed during finalization.

HB560 Engrossed → HB560 Reengrossed · 3 edits · Jun 2, 2025

MINOR

The bill underwent technical formatting updates, including changing the document title from 'Engrossed' to 'Reengrossed' and correcting a typo in the legislative purpose section. A minor grammatical fix was also made to a sentence regarding qui tam actions by removing the word 'Subpart of'.

TECHNICAL

Corrected a typo in the bill's purpose statement by changing 'pursing' to 'pursuing'.

Fixed a grammatical error in the qui tam section by removing the word 'of' from 'Subpart of C'.

Updated the document header to reflect the bill's new status as 'Reengrossed'.

MEDICAID: Provides relative to the Medical Assistance Programs Integrity Act (EN SEE FISC NOTE GF RV)

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