Louisiana § RS 46:460.76 - Prepayment review
Full text of Louisiana Louisiana Civil Code § RS 46:460.76 — Prepayment review, with citation guidance and answers to common questions.
§ RS 46:460.76. Prepayment review
A. A managed care organization or a contractor, assignee, agent, or entity acting on the behalf of a managed care organization shall be prohibited from requiring any enrolled provider to be subject to prepayment review unless the requirement is implemented directly by the department and in accordance with the provisions of the Medical Assistance Programs Integrity Law, R.S. 46:437.1 et seq.
B. For the purposes of this Section, "prepayment review" means any action by a managed care organization or a contractor, assignee, agent, or entity acting on the behalf of a managed care organization requiring a healthcare provider to provide medical record documentation in conjunction with or after the submission of a claim for payment for medical services rendered, but before the claim has been adjudicated by the managed care organization.
C.(1) Nothing in this Section shall prohibit a managed care organization from notifying the department of healthcare providers suspected of committing fraud and abuse.
(2) Nothing in this Section shall prohibit the department from requiring all managed care organizations to coordinate efforts to combat and prevent fraud and abuse pursuant to any requirements ordered by the department in accordance with the Medical Assistance Programs Integrity Law, R.S. 46:437.1 et seq.
D. The provisions of this Section shall not apply to any dental coordinated care network as defined in R.S. 46:460.51.
Acts 2022, No. 534, §1.
Source: official Louisiana text · Last verified 2026-08-27
Frequently Asked Questions About Louisiana § RS 46:460.76
What does Louisiana Civil Code § RS 46:460.76 cover?
Section RS 46:460.76 ("Prepayment review") is part of the Louisiana Civil Code, the codified statutory law of Louisiana. It sets out the legal rule or procedure described in the text above. Statutes are amended regularly, so always verify against the official source.
How do I cite Louisiana § RS 46:460.76?
A common citation format is "Louisiana Civil Code § RS 46:460.76" (Louisiana). Legal writing may require the code abbreviation, section number, and year or edition. Match the style required by your court, professor, or publisher.
Is this the official text of Louisiana law?
No. This page is for research and education and may not include the most recent amendments. For official current law, check the Louisiana official source linked on this page or consult a licensed Louisiana attorney.
How does Louisiana § RS 46:460.76 apply to my situation?
Statutes are interpreted in context, and application depends on your specific facts. Only a licensed attorney in Louisiana can advise on how this section applies to you. Contact your state or local bar association for a referral.
Sources & Verification
Not legal advice. Verify against the official source and consult a licensed attorney in Louisiana.