1. A. The following actions are not sanctions nor subject to an informal hearing or appeal:

   1. 1. referral to a state, federal, or professional licensing authority;
   2. 2. referral to the MFCU or any other law enforcement or prosecutorial authority;
   3. 3. referral to governing boards, peer review groups, or similar entities;
   4. 4. requirements the provider receives education and training in laws, rules, policies, and procedures, including billing;
   5. 5. prepayment review;
   6. 6. placement on manual claims review prior to payment being made;
   7. 7. require the provider to receive prior authorization prior to providing any services;
   8. 8. remove or restrict the provider’s use of electronic billing;
   9. 9. an increase of any required bond or other security already posted as a condition of continued enrollment; and
   10. 10. any restrictions, terms, or conditions a provider agrees to.

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 52:699 (May 2026).