Louisiana Revised Statutes Tit. 46, § 440.12. Definitions

(1) “Adverse determination” means any decision rendered by the recovery audit contractor that results in a payment to a provider for a claim or service being reduced either partially or completely.

(2) “Contractor” and “recovery audit contractor” mean a Medicaid recovery audit contractor selected by the department to perform audits for the purpose of ensuring Medicaid program integrity in accordance with the provisions of 42 CFR 455 et seq.

(3) “Department” means the Louisiana Department of Health.

(4) “Medicaid” and “medical assistance program” mean the medical assistance program provided for in Title XIX of the Social Security Act.

(5) “Provider” means any healthcare entity enrolled with the department as a provider in the Medicaid program.