Louisiana Administrative Code

A. The Department of Health and Hospitals, Office of Management and Finance, HIV Program Office has developed example forms that can be used in this program. These include client eligibility checklist and release of medical information form. In addition, a client service utilizat…

A. Unless the context otherwise requires, the words defined in §13701 shall have the following meanings in LAC 48:V.Chapter 137. Billable Submitter—individual authorized to submit specimens for scientific analysis by the Division of Laboratories that does not fall into one of the…

A. Regulation 98 is promulgated by the Commissioner of Insurance (commissioner) of the Louisiana Department of Insurance (department) pursuant to authority granted under the Louisiana Insurance Code Title 22, R.S. 22:1 et seq., the "Audited Financial Reports Law" R.S. 22:671 et s…

A. The purpose of Regulation 98 is to improve the surveillance of the financial condition of insurers by the department by requiring: 1. an annual audit of financial statements reporting the financial position and the results of operations of insurers by independent certified pub…

B. Notwithstanding the premium threshold in Subsection A of this Section, the commissioner may require an insurer to file management's report of internal control over financial reporting if the insurer is in any RBC level event, or is deemed to be in hazardous financial condition…

A. All insurers shall have an annual audit by an independent certified public accountant and shall file an audited financial report with the commissioner on or before June 1 for the year ended December 31 immediately preceding. The commissioner may require an insurer to file an A…

A. The annual audited financial report shall report the financial position of the insurer as of the end of the most recent calendar year and the results of its operations, cash flows and changes in capital and surplus for the year then ended in conformity with statutory accountin…

A. Each insurer required by Regulation 98 to file an annual audited financial report must within 60 days after becoming subject to the requirement, register with the commissioner in writing the name and address of the independent certified public accountant or accounting firm ret…

A. The commissioner shall not recognize a person or firm as a qualified independent certified public accountant if the person or firm: 1. is not in good standing with the AICPA and in all states in which the accountant is licensed to practice, or, for a Canadian or British compan…

A. An insurer may make written application to the commissioner for approval to file audited consolidated or combined financial statements in lieu of separate annual audited financial statements if the insurer is part of a group of insurance companies that utilizes a pooling or 10…

A. Financial statements furnished pursuant to §13709 shall be examined by the independent certified public accountant. The audit of the insurer's financial statements shall be conducted in accordance with generally accepted auditing standards. In accordance with AU Section 319 of…

A. The insurer required to furnish the annual audited financial report shall require the independent certified public accountant to report, in writing, within five business days to the board of directors or its audit committee any determination by the independent certified public…

A. In addition to the annual audited financial report, each insurer shall furnish the commissioner with a written communication as to any unremediated material weaknesses in its internal control over financial reporting noted during the audit. Such communication shall be prepared…

A. The accountant shall furnish the insurer in connection with, and for inclusion in, the filing of the annual audited financial report, a letter stating: 1. that the accountant is independent with respect to the insurer and conforms to the standards of his or her profession as c…

A. Workpapers are the records kept by the independent certified public accountant of the procedures followed, the tests performed, the information obtained, and the conclusions reached pertinent to the accountant's audit of the financial statements of an insurer. Accordingly, wor…

A. This Section shall not apply to foreign or alien insurers licensed in this state or an insurer that is a SOX Compliant Entity or a direct or indirect wholly-owned subsidiary of a SOX Compliant Entity. 1. The audit committee shall be directly responsible for the appointment, co…

A. Exemption. An insurer is exempt from the requirements of this Section if: 1. the insurer has annual direct written and unaffiliated assumed premium, including international direct and assumed premium but excluding premiums reinsured with the Federal Crop Insurance Corporation …

A. No director or officer of an insurer shall, directly or indirectly: 1. make or cause to be made a materially false or misleading statement to an accountant in connection with any audit, review or communication required under Regulation 98; or 2. omit to state, or cause another…

A. Every insurer required to file an audited financial report pursuant to Regulation 98 that has annual direct written and assumed premiums of $500,000,000 or more, excluding premiums reinsured with the Federal Crop Insurance Corporation and the Federal Flood Program, shall prepa…

A. Upon written application of any insurer, the commissioner may grant an exemption from compliance with any and all provisions of Regulation 98 if the commissioner finds, upon review of the application, that compliance with Regulation 98 would constitute a financial or organizat…

A. In the case of Canadian and British insurers, the annual audited financial report shall be defined as the annual statement of total business on the form filed by such companies with their supervision authority duly audited by an independent chartered accountant. B. For such in…

A. If any Section or portion of a Section of Regulation 98 or its applicability to any person or circumstance is held invalid by a court, the remainder of the regulation or the applicability of the provision to other persons or circumstances shall not be affected.

A. Regulation 98 shall become effective upon promulgation in the Louisiana Register.

A. Individual family support (IFS) services are direct support and assistance services, provided in the beneficiary’s home or in the community, that allow the beneficiary to achieve and/or maintain increased independence, productivity, enhanced family functioning and inclusion in…

A. Center-based respite (CBR) care is temporary, short-term care provided to a beneficiary with developmental disabilities who requires support and/or supervision in his/her day-to-day life due to the absence or relief of the primary caregiver. While receiving center-based respit…

A. Community life engagement development (CLE) facilitates the development of opportunities to assist beneficiaries in becoming involved in the community through the creation of natural supports. The purpose of CLE is to encourage and foster the development of meaningful relation…

A. Supported independent living (SIL) assists the beneficiary to acquire, improve or maintain those social and adaptive skills necessary to enable a beneficiary to reside in the community and to participate as independently as possible. SIL services include assistance and/or trai…

A. Substitute family care (SFC) provides for day programming, transportation, independent living training, community integration, homemaker, chore, attendant care and companion services, and medication oversight (to the extent permitted under state law) to beneficiaries residing …

A. Day habilitation is provided in a community-based setting and provides the beneficiary assistance with social and adaptive skills necessary to enable the beneficiary to participate as independently as possible in the community. These services focus on socialization with meanin…

A. Supported employment is competitive work in an integrated work setting, or employment in an integrated work setting in which the beneficiaries are working toward competitive work that is consistent with the strengths, resources, priorities, interests, and informed choice of be…

A. Transportation provided for the beneficiary to the site of the day habilitation or supported employment model, or between the day habilitation and supported employment model site (if the beneficiary receives services in more than one place) is reimbursable when day habilitatio…

A. Prevocational services are individualized, person centered services that assist the beneficiary in establishing their path to obtain individualized community employment. This service is time limited and targeted for people who have an interest in becoming employed in an indivi…

A. Environmental accessibility adaptations are physical adaptations to the home or a vehicle that are necessary to ensure the health, welfare, and safety of the beneficiary or that enable him/her to function with greater independence in the home and/or community. Without these se…

A. Specialized medical equipment and supplies (SMES) are devices, controls, or appliances which enable the beneficiary to: 1. increase his/her ability to perform the activities of daily living; 2. ensure safety; or 3. perceive, control and communicate with the environment in whic…

A. Personal emergency response systems (PERS) is a rented electronic device connected to the person's phone and programmed to signal a response center which enables a beneficiary to secure help in an emergency. B. Beneficiary Qualifications. Personal emergency response systems (P…

A. Professional services are services designed to increase the beneficiary’s independence, participation and productivity in the home, work and community. Beneficiaries, up to the age of 21, who participate in NOW must access these services through the Early and Periodic Screenin…

A. Skilled nursing services are medically necessary nursing services ordered by a physician and provided by a licensed registered nurse, nurse practitioner, or a licensed practical nurse working under the supervision of a registered nurse. Skilled nursing services shall be provid…

A. One-time transitional expenses are those allowable one-time, set-up expenses incurred by beneficiaries who are being transitioned from an ICF-DD to his/her own home or apartment of their choice in the community of their choice. Own home shall mean the beneficiary’s own place o…

A. Adult companion care services assist the beneficiary to achieve and/or maintain the outcomes of increased independence, productivity and inclusion in the community. These services are designed for an individual who lives independently and can manage his/her own household with …

A. Housing stabilization transition service enables beneficiaries who are transitioning into a permanent supportive housing unit, including those transitioning from institutions, to secure their own housing. The service is provided while the beneficiary is in an institution and p…

A. Housing stabilization service enables waiver beneficiaries to maintain their own housing as set forth in the beneficiary’s approved CPOC. Services must be provided in the home or a community setting. This service includes the following components: 1. conducting a housing asses…

A. Monitored in-home caregiving (MIHC) services are provided by a principal caregiver to a beneficiary who lives in a private unlicensed residence. 1. The goal of this service is to provide a community-based option that provides continuous care, supports, and professional oversig…

A. Dental services are available to adult beneficiaries over the age of 21 as of component of the NOW. Covered dental services include: 1. adult diagnostic services; 2. preventative services; 3. restorative services; 4. endodontics; 5. periodontics; 6. prosthodontics; 7. oral and…

A. Contribution payroll files and payment of employee and employer contributions are required by the tenth of each month, covering the preceding month. B. Employers may pay contributions through electronic means or with a check.

A. Interest may be charged for payments submitted after the tenth of the month. B. Interest is calculated based on the system’s actuarial valuation rate. C. Payments more than 60 days late shall be reported to the board of trustees. D. The board of trustees may certify delinquent…

A. The purpose of this Subchapter is to implement 40 CFR Part 51, Subpart W to fulfill requirements of Section 176(c) of the Clean Air Act (CAA), as amended (42 U.S.C. 7401 et seq.), with respect to the conformity of general federal actions to the applicable state implementation …

A. The conformity provisions of this Subchapter shall apply in all criteria pollutant nonattainment and maintenance areas and shall apply to all federal action as defined and required in this Subchapter.

A. No department, agency, or instrumentality of the federal government shall engage in, support in any way, provide financial assistance for, license, permit, or approve any activity which does not conform to an applicable implementation plan. B. A federal agency must make a dete…

A. Terms used, but not defined in this part, shall have the meaning given them by the CAA and LAC 33:III, in that order of priority. Affected Federal Land Manager―the federal agency or the federal official charged with direct responsibility for management of an area designated as…

A. Conformity determinations for federal actions related to transportation plans, programs, and projects developed, funded, or approved under Title 23 U.S.C. or the Federal Transit Act (49 U.S.C. 1601 et seq.) must meet the procedures and criteria of LAC 33:III.Chapter 14.Subchap…