La. Admin. Code tit. 50 § I-4221

Current through Register Vol. 50, No. 9, September 20, 2024

Section I-4221 - Tip Rewards

A. The secretary may approve a reward of 10 percent of the actual monies recovered from a person, with a maximum reward of $2,000 to a person who submits information to the secretary which results in a recovery under this Chapter or the provisions of the Medical Assistance Program Integrity Law.

B. The secretary shall grant rewards only to the extent monies are appropriated for that purpose from the Medical Assistance Programs Fraud Detection Fund. The approval of a reward is solely at the discretion of the secretary. In making a determination of a reward, the secretary shall consider the extent to which the tip information contributed to the investigation and recovery of monies. The person providing the information need not have requested a reward in order to be considered for an award by the secretary.

C. No reward shall be made to any person if:

1. the information was previously known to the department or criminal investigators;

2. a person planned or participated in the action resulting in the investigation;

3. a person who is, or was at the time of the tip, excluded from participation in the Medical Assistance Program or subject to recovery under this Chapter or the Medical Assistance Program Integrity Law;

4. a person who is or was a public employee or public official or person who was or is acting on behalf of the state if the person has or had a duty or obligation to report, investigate, or pursue allegations of wrongdoing or misconduct by health care providers or Medicaid recipients unless that individual has not been employed or had such duties and obligation for a period of two years prior to providing the information.

La. Admin. Code tit. 50, § I-4221

Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 25:1650 (September 1999), repromulgated LR 29:603 (April 2003).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254, 46:437.4, R. S. 46:440.2 and 46:437.1-46:440.3 (Medical Assistance Program Integrity Law).