Louisiana
Administrative Code
Title 46
PROFESSIONAL AND OCCUPATIONAL STANDARDS
Part LXIII. Psychologists
Note: Updates to the
LAC my be obtained from
http://doa.louisiana.gov/osr/lac/46v63/46v63.doc
Chapter 21.
Disclosure of Financial Interests and Prohibited Payments
§2101. Scope and
Purpose of Chapter
A. The rules of
this Chapter interpret, implement and provide for the enforcement of R.S.
37:1744 and R.S. 37:1745 requiring disclosure of a psychologist_s
financial interest in another health care provider to whom or to which the
psychologist refers a patient, and prohibiting certain payments in return
for referral or soliciting patients. It is the purpose of these rules to
prevent payments by or to a psychologist as a financial incentive for the
referral of patients to a psychologist or other health care provider for
diagnostic or therapeutic services or items. These rules should be
interpreted, construed and applied so as to give effect to such purposes
and intent.
AUTHORITY NOTE:
Promulgated in accordance with R.S. 37:1744, R.S. 37:1745.
HISTORICAL NOTE:
Promulgated by the Department of Health and Hospitals, Board of Examiners
of Psychologists, LR 21:1335 (December 1995).
§2103.
Definitions
A. For the purpose
of this Chapter, the following terms are defined as follows:
1. "Board"
the Louisiana State Board of Examiners of Psychologists.
2.
"Financial Interest" a significant ownership or investment interest
established through debt, equity or other means and held, directly or
indirectly, by a psychologist or a member of the psychologist's immediate
family, or any form of direct or indirect remuneration of referral.
3. "Group
Practice" a group of two or more psychologists, operating in whole or in
part as psychologists, legally organized as a general partnership,
registered limited liability partnership, professional psychological
corporation, limited liability company, foundation, nonprofit corporation
or similar organization or association, including a faculty practice plan.
4."Health
Care Item" any substance, product, device, equipment, supplies or other
tangible good or article which may be used or is useful in the provision
of health care.
5. "Health
Care Provider" any person licensed by a department, board, commission or
other agency of the State of Louisiana to provide, or which does in fact
provide, preventative, diagnostic, or therapeutic health care services or
items.
6.
"Immediate Family" as respects a psychologist, the psychologist's spouse,
children, grandchildren, parents, grandparents and siblings.
7.
"Investment Interests'' a security issued by an entity, including, without
limitation, shares in a corporation, interests in or units of a
partnership, bonds, debentures, notes or other debt instruments.
8. "Payment"
the tender, transfer, exchange, distribution or provision of money, goods,
services or anything of economic value.
9. "Person"
a natural person or a partnership, corporation, organization, association,
facility, institution or any governmental subdivision, department, board,
commission or other entity.
10.
"Psychologist" any individual licensed to practice psychology by the
Louisiana State Board of Examiners of Psychologists.
11.
"Psychologist Applicant/Candidate" a graduate of an approved doctoral
program in psychology who has applied to the board for licensure and who
is practicing under the supervision of a licensed psychologist under
applicable provisions of LAC Title 46, Part LXIII.
12.
"Referral" any direction, recommendation or suggestion given by the
psychologist to a patient, directly or indirectly, which is likely to
determine, control or influence the patient's choice of another health
care provider for the provision of health care services or items.
13.
"Remuneration for Referral" any arrangement or scheme, involving any
remuneration, directly or indirectly, in cash or in kind, between a
psychologist, or an immediate family member of such psychologist, and
another health care provider which is intended to induce referrals by the
psychologist to the health care provider or by the health care provider to
the psychologist, other than the amount paid by an employer to an employee
who has a bona fide employment relationship with the employer, for
employment in the furnishing of any health care item or service.
B. Construction.
As used here and after in this Chapter, the term “psychologist” is deemed
to likewise incorporate psychologist applicant/candidate as defined
herein.
AUTHORITY NOTE:
Promulgated in accordance with R.S. 37:1744, R.S. 37:1745.
HISTORICAL NOTE:
Promulgated by the Department of Health and Hospitals, Board of Examiners
of Psychologists, LR 21:1335 (December 1995).
Subchapter A. Disclosure of Financial
Interest in Third-Party Health Care Providers
§2105. Required
Disclosure of Financial Interests
A. Mandatory
disclosure. The psychologist shall not make any referral of a patient
outside of the psychologist_s group practice for the provision of health
care items or services by any health care provider in which the referring
psychologist has a significant financial interest unless, in advance of
such referral, the referring psychologist discloses to the patient, in
accordance with relative provision of this Chapter, the existence and
nature of financial interests.
B. Definition:
Significant Ownership or Investment Interest. For the purpose of these
regulations, an ownership or investment interest shall be considered
"significant" within the meaning of §2105.A, if such interest satisfies
any of the following tests:
1. such
interests, in dollar amount or value, represents five percent or more of
the gross assets of the health care provider in which an interest is held;
2. such
interest represents five percent or more of the voting securities of the
health care provider in which such interest is held.
AUTHORITY NOTE:
Promulgated in accordance with R.S. 37:1744, R.S. 37:1745.
HISTORICAL NOTE:
Promulgated by the Department of Health and Hospitals, Board of Examiners
of Psychologists, LR 21:1335 (December 1995).
§2107. Prohibited
Arrangements
A. Any arrangement
or scheme including cross referral arrangements, which the psychologist
knows, or should know has a principal purpose of ensuring or inducing
referrals by the psychologist to another health care provider which, if
made directly by the psychologist, would be a violation of §2105 shall be
deemed a violation of §2105.
AUTHORITY NOTE:
Promulgated in accordance with R.S. 37:1744, R.S. 37:1745.
HISTORICAL NOTE:
Promulgated by the Department of Health and Hospitals, Board of Examiners
of Psychologists, LR 21:1335 (December 1995).
§2109. Form of
Disclosure
A. Required
Contents. The disclosure required by §2105 of this Chapter shall be made
in writing, shall be furnished to the patient, or the patient_s authorized
representative, prior to or at the time of making the referral, and shall
include:
1. the
psychologist_s name, address and phone number;
2. the name
and address of the health care provider to whom the patient is being
referred by the psychologist;
3. the
nature of the items or services which the patient is to receive from the
health care provider to which the patient is being referred; and
4. the
existence and nature of the psychologist_s financial interest in the
health care provider to whom or to which the patient is being referred.
B. Permissible
Contents. The form of disclosure required by §2105 of this Chapter may
include a signed acknowledgment by the patient or the patient_s authorized
representative that the required disclosure has been given.
C. Approved Form.
Notice to a patient given substantially in the form of Disclosure of
Financial Interest, found at the end of this Chapter, shall be
presumptively deemed to satisfy the disclosure requirements of this
Subchapter.
AUTHORITY NOTE:
Promulgated in accordance with R.S. 37:1744, R.S. 37:1745.
HISTORICAL NOTE:
Promulgated by the Department of Health and Hospitals, Board of Examiners
of Psychologists, LR 21:1335 (December 1995).
Subchapter B. Illegal Payments
§2111.
Prohibition of Remuneration for Referrals
A. A psychologist
shall not knowingly or willfully make or offer to make any payment,
directly or indirectly, overtly or covertly, in cash or in kind, to induce
another person to refer an individual to the psychologist for the
furnishing or arranging of the furnishing of any health care item or
service.
B. A psychologist
shall not knowingly or willfully solicit, receive or accept any payment,
directly or indirectly, overtly or covertly, in cash or in kind, or in
return for referring a patient to a health care provider for the
furnishing or arranging for the furnishing of any health care item or
service.
AUTHORITY NOTE:
Promulgated in accordance with R.S. 37:1744, R.S. 37:1745.
HISTORICAL NOTE:
Promulgated by the Department of Health and Hospitals, Board of Examiners
of Psychologists, LR 21:1335 (December 1995).
§2113. Exceptions
A. A proportional
return on investment. Payments or distributions by any entity
representing a direct return on investment based upon a percentage of
ownership shall not be deemed a payment prohibited by R.S. 37:1745.B or by
§2111 of these rules provided that:
1. the
amount of payment to an investor in return for the investment interest is
directly proportional to the amount or value of the capital investment,
including the fair market value of any pre-operational services rendered
of that investor;
2. the terms
on which an investment interest was or is offered to an investor who is in
a position to make or influence referrals to, furnish items or services
to, or otherwise generate business for the entity must be no different
than the terms offered to other investors;
3. the terms
which an investment interest was or is offered to an investor who is in a
position to make or influence referrals to, furnish items or services to
or otherwise generate for the entity must not be related to the previous
expected volume of referrals, items or services furnished or the amount of
business otherwise generated by that investor to the entity;
4. there is
no requirement that an investor make referrals to, be in a position to
make or influence referrals to, furnish items or services to, or otherwise
generate business for the entity as a condition of becoming or remaining
an investor;
5. the
entity or other investor does not market or furnish the entity_s items or
services to investors differently than to non-investors; and
6. the
entity does not loan funds to or guarantee a loan for an investor who is
in a position to make or influence referrals to, furnish items or services
to, or otherwise generate business for the entity if the investor uses any
part of such loan to obtain the investment interest.
B. General
Exceptions. Any payment, remuneration, practice or arrangement which is
not prohibited by or unlawful under §1128.B(b) of the Federal Social
Security Act (act), 42 U.S.C. §1320a-7b(b), as amended, with respect to
health care items or services for which payment may be made under Title
XVIII or Title XIX of the act, including those payments and practices
sanctioned by the secretary of the United States Department of Health and
Human Services, through regulations promulgated at 42 C.F.R. §1001.952,
shall not be deemed a payment prohibited by R.S. 37:1745.B or by §2111 of
these rules with respect to health care items or services for which
payment may be made by any patient or third-party payers, whether a
governmental or private payer, on behalf of a patient.
AUTHORITY NOTE:
Promulgated in accordance with R.S. 37:1744, R.S. 37:1745.
HISTORICAL NOTE:
Promulgated by the Department of Health and Hospitals, Board of Examiners
of Psychologists, LR 21:1335 (December 1995).
§2115. Effect of
Violation
A. Any violation
of or failure of compliance with the prohibitions and provisions of §2105
and/or §2111 of this Chapter shall be deemed grounds for disciplinary
proceedings against a psychologist, providing cause for the board to deny,
revoke, suspend, restrict, refuse to issue or impose probationary or other
restrictions on any license held or applied for by a psychologist found
guilty of such violation.
B. Administrative
Sanctions. In addition to the sanctions provided for by §2115.A, the
board may order the additional sanctions or penalties described below:
1. Upon
proof of a violation of §2105 of this Chapter by a psychologist, the board
may order that all or any portion of any amounts paid by a patient, and/or
any third-party payer on behalf of the patient, for health care items or
services furnished upon a referral by the psychologist in violation of
§2105 be refunded by the psychologist to such patient and/or third-party
payer together with legal interest on such payment at the rate prescribe
by law calculated from the date on which any such payment was made by the
patient and/or third-party payers.
2. Upon
proof of a violation of §2111 of this Chapter by a psychologist, the board
may order a fine of not more than $500 for each count or separate offense,
plus administrative costs.
AUTHORITY NOTE:
Promulgated in accordance with R.S. 37:1744, R.S. 37:1745.
HISTORICAL NOTE:
Promulgated by the Department of Health and Hospitals, Board of Examiners
of Psychologists, LR 21:1335 (December 1995).
§2117. Disclosure
of Financial Interest
(Name of Psychologist or Group)
(Address)
(Telephone Number)
______________
DISCLOSURE OF FINANCIAL INTEREST
As Required by R. S. 37:1744; R. S.
37:1745, and
LAC 46:LXIII.2101-2115
TO:
______________________________________Date:______________________
(Name of Patient to
be Referred)
_______________________________________
(Patient Address)
_______________________________________
Louisiana law requires
psychologists and other health care providers to make certain disclosures
to a patient when they refer a patient to another health care provider or
facility in which the psychologist has a significant financial interest.
(I am/we are) referring you, or the named patient for whom you are legal
representative, to:
__________________________________________________________________
(Name and Address of
Provider to Whom Patient is Referred)
to obtain the following health care
services, products or items:
____________________________________________________________________
(Purpose of the Referral)
(I/we) have a financial interest
in the health care provider to whom we are referring you, the nature and
extent of which are as follows:
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
PATIENT ACKNOWLEDGEMENT
I, the above named patient, or
legal representative of such patient, hereby acknowledge receipt, on the
date indicated and prior to the described referral, of a copy of the
foregoing Disclosure of Financial Interest.
_______________________________________________
(Signature of Patient or Patient’s
Representative)
AUTHORITY NOTE:
Promulgated in accordance with R.S. 37:1744, R.S. 37:1745.
HISTORICAL NOTE:
Promulgated by the Department of Health and Hospitals, Board of Examiners
of Psychologists, LR 21:1335 (December 1995).
