1. A. The Department of Health may remove a service provider from the waiver provider freedom of choice list and offer freedom of choice to waiver participants when:

   1. 1. one or more of the following departmental proceedings are pending against a waiver participant’s service provider:

      1. a. revocation of the provider’s home and community-based services license;
      2. b. exclusion from the Medicaid Program;
      3. c. termination from the Medicaid Program; or
      4. d. withholding of Medicaid reimbursement as authorized by the department’s surveillance and utilization review (SURS) Rule (LAC 50:I.Chapter 41);
   2. 2. the service provider fails to timely renew its home and community-based services license as required by the home and community-based services providers licensing standards Rule (LAC 48:I.Chapter 50); or
   3. 3. the Louisiana Attorney General’s Office has seized the assets of the service provider.

2. B. The department may offer recipients the freedom to choose another provider if/when the owner(s), operator(s), or member(s) of the governing body of the provider agency is/are under investigation related to:

   1. 1. bribery or extortion;
   2. 2. tax evasion or tax fraud;
   3. 3. money laundering;
   4. 4. securities or exchange fraud;
   5. 5. wire or mail fraud;
   6. 6. violence against a person;
   7. 7. act(s) against the aged, children or infirmed; or
   8. 8. any crime involving public funds

Authority Note

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

Historical Note

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 40:1098 (June 2014), amended by the Department of Health, Bureau of Health Services Financing, the Office of Aging and Adult Services and the Office for Citizens with Developmental Disabilities, LR 43:1978 (October 2017).