1. A. Attributing, imputing, extending, or imposing violations shall be done at the discretion of the BHSF director or PIU section chief. Violations of a provider’s obligations or prohibited conduct may be imputed in the following manner.

   1. 1. The conduct of a provider-in-fact or a managing employee is always attributable to the provider.

   2. 2. The conduct of a provider’s agent, billing agent, or affiliates may be imputed to the provider or provider-in-fact if the conduct:

      1. a. was performed within the course of his duties for the provider; or
      2. b. was effectuated by or with the knowledge or approval of the provider.
   3. 3. The conduct of any person or entity operating on behalf of a provider may be imputed to the provider.
   4. 4. The provider is responsible for the conduct of his officers, employees, contractors, agents, or affiliates. The conduct of these persons may be imputed to the provider.
   5. 5. A violation or sanction under one provider number or NPI may be extended to all provider numbers or NPIs the provider possesses or obtains.
   6. 6. On fee-for-service claims, recoveries may be obtained by offsetting remittances due to the provider from any provider number or NPI the provider holds or obtains. On managed care claims, if provided for in the contract between the MCO and LDH, recoveries may be obtained through PMPM offsets, and the MCO may recover those offsets from the provider.
   7. 7. All sanctions imposed on a provider remain in effect until the sanctions have been satisfied.
   8. 8. Any person who purchases, merges, or otherwise consolidates with a sanctioned provider assumes liability for those sanctions.
   9. 9. Any person who employs or affiliates with a sanctioned provider assumes liability for those sanctions to the extent that person receives payment for services the sanctioned employee or affiliate provides.
   10. 10. A referring provider may be held responsible for overpayments the referral causes if the referring provider knew that such overpayments were likely to occur.
   11. 11. Providers which are legal entities may be held solidarily liable for monetary sanctions assessed on any person within that legal entity if the entity received any economic benefit related to the overpayment.
   12. 12. Payment withholdings on a provider may be extended to all provider and/or NPI numbers the provider holds or obtains.
   13. 13. A monetary sanction owed to the department can be imputed to a group or entity to which the provider is linked.

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 52:694 (May 2026).