LAC 50:I.4201 – Investigations, Claims, and Compliance Review

A. Investigations, pre-payment, post-payment, and compliance reviews are conducted at the discretion of the department or other health oversight agency. They may be initiated without cause and require no justification.
B. Unless consent is obtained from the investigating agency, no information regarding an active criminal or outside government investigation shall be disclosed to the provider.
C. The DAL shall not require information related to an active criminal or outside governmental investigation be disclosed as part of any appeal. The DAL shall not use the non-disclosure as grounds to overturn any department assessed sanction.
D. If a provider has been assessed a non-monetary sanction, including suspension or exclusion due to an active criminal or outside governmental investigation, certification from the investigating agency that the investigation is still active is sufficient cause to maintain the sanction.

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and 46:437.1-46:440.3.

HISTORICAL NOTE: Promulgated by the Department of Health, Bureau of Health Services Financing, LR 52:691 (May 2026).