1. A. The department or a health oversight agency may conduct a compliance investigation. A compliance review ensures the provider conducts its business in conformity with the Medicaid program’s laws, rules, regulations, and sub-regulatory guidance.
2. B. A compliance review may be initiated as its own matter or as part of an investigation, pre-payment or post-payment review.
3. C. A sanction the department assesses as part of a compliance investigation is appealable and subject to an informal hearing.

Authority Note

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

Historical Note

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