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LA HB560
Bill
Status
6/8/2025
Primary Sponsor
Peter Egan
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AI Summary
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Amends Louisiana's Medical Assistance Programs Integrity Law to strengthen prosecution and investigation of Medicaid fraud, clarifying that "knowing" violations require no proof of specific intent to defraud
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Expands prohibited conduct to include managed care organizations that knowingly fail to provide required healthcare benefits, withhold required information from state agencies, or engage in fraudulent enrollment/marketing activities
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Establishes that the Secretary may only pursue civil fraud actions if the Attorney General declines in writing after referral, and designates the 19th Judicial District Court (East Baton Rouge) as the primary venue for fraud cases
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Enhances qui tam (whistleblower) action procedures by requiring court and Attorney General consent for dismissal, allowing the state to settle over a whistleblower's objection if the court finds the settlement fair, and permitting courts to limit whistleblower participation if it interferes with state prosecution
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Removes the previous $1,000 minimum threshold for bringing fraud actions and adds provisions making criminal fraud convictions binding in subsequent civil proceedings under this law
Legislative Description
Provides relative to the Medical Assistance Programs Integrity Act (EN SEE FISC NOTE GF RV)
MEDICAID
Last Action
Effective date: 08/01/2025.
6/8/2025