Terms Used In Louisiana Revised Statutes > Title 34 > Chapter 4 > Part IV - Motorboats and Vessels

• Administrative adjudication: means adjudication and the adjudication process contained in the Administrative Procedure Act. See Louisiana Revised Statutes 46:437.3
• 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. See Louisiana Revised Statutes 46:440.12
• Agent: means a person who is employed by or has a contractual relationship with a health care provider or who acts on behalf of the health care provider. See Louisiana Revised Statutes 46:437.3
• Allegation: something that someone says happened.
• Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
• Billing agent: means an agent who performs any or all of the health care provider's billing functions. See Louisiana Revised Statutes 46:437.3
• Claim: means any request or demand, whether under a contract or otherwise, for money or property, whether or not the state or department has title to the money or property, that is drawn in whole or in part on medical assistance programs funds that are either of the following:

              (a) Presented to an officer, employee, or agent of the state or department. See Louisiana Revised Statutes 46:437.3

• Commission: means the Louisiana Wildlife and Fisheries Commission. See Louisiana Revised Statutes 34:851.2
• Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
• Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
• Conviction: A judgement of guilt against a criminal defendant.
• Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
• Department: means the Department of Children and Family Services. See Louisiana Revised Statutes 46:322
• Department: means the Louisiana Department of Health. See Louisiana Revised Statutes 46:440.12
• Department: means the Louisiana Department of Health. See Louisiana Revised Statutes 46:437.3
• Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
• Dismissal: The dropping of a case by the judge without further consideration or hearing. ^Source:
• Embezzlement: In most states, embezzlement is defined as theft/larceny of assets (money or property) by a person in a position of trust or responsibility over those assets. Embezzlement typically occurs in the employment and corporate settings. ^{Source: OCC}
• Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
• False or fraudulent claim: means a claim which the health care provider or his billing agent submits knowing the claim to be false, fictitious, untrue, or misleading in regard to any material information. See Louisiana Revised Statutes 46:437.3
• Fiduciary: A trustee, executor, or administrator.
• FNS: means the Food and Nutrition Service of the United States Department of Agriculture, the office of the federal government that administers SNAP. See Louisiana Revised Statutes 46:322
• Fraud: Intentional deception resulting in injury to another.
• Grantor: The person who establishes a trust and places property into it.
• Health care provider: means any person furnishing or claiming to furnish a good, service, or supply under the medical assistance programs, any other person defined as a health care provider by federal or state law or by rule, and a provider-in-fact. See Louisiana Revised Statutes 46:437.3
• Houseboat: means a vessel constructed for the primary purpose of a temporary or permanent dwelling without an effective means of propulsion for safe navigation. See Louisiana Revised Statutes 34:851.2
• Indictment: The formal charge issued by a grand jury stating that there is enough evidence that the defendant committed the crime to justify having a trial; it is used primarily for felonies.
• Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
• Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
• knowingly: means that the person has actual knowledge of the information or acts in deliberate ignorance or reckless disregard of the truth or falsity of the information. See Louisiana Revised Statutes 46:437.3
• Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
• Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
• Louisiana Colonial Trails: means a system of trails or roads identified as the migration route of the Camino Real in the western part of the state from Natchitoches to the Texas border and the Harrisonburg Road from Natchitoches through east central Louisiana to the Mississippi River. See Louisiana Revised Statutes 56:1952
• Managing employee: means a person who exercises operational or managerial control over, or who directly or indirectly conducts, the day-to-day operations of a health care provider. See Louisiana Revised Statutes 46:437.3
• Material: means having a natural tendency to influence, or be capable of influencing, the payment or receipt of money or property. See Louisiana Revised Statutes 46:437.3
• Medical assistance programs: means the Medical Assistance Program (Title XIX of the Social Security Act), commonly referred to as "Medicaid" and other programs operated by and funded in the department which provide payment to health care providers. See Louisiana Revised Statutes 46:437.3
• Misrepresentation: means the knowing failure to truthfully or fully disclose any and all information required, or the concealment of any and all information required on a claim or a provider agreement or the making of a false or misleading statement to the department relative to the medical assistance programs. See Louisiana Revised Statutes 46:437.3
• Motorboat: means any vessel equipped with or propelled by any type of machinery whether or not such machinery is the principal source of propulsion but shall not include a vessel which has a valid marine document issued by the Bureau of Customs of the United States Government or any federal agency successor thereto, unless the vessel is a recreational use vessel. See Louisiana Revised Statutes 34:851.2
• Nolo contendere: No contest-has the same effect as a plea of guilty, as far as the criminal sentence is concerned, but may not be considered as an admission of guilt for any other purpose.
• Obligation: means an established duty, whether or not fixed, arising from an express or implied contractual, grantor, grantee, or licensor-licensee relationship, from a free-based or similar relationship, from statute or regulation, or from the retention of any overpayment. See Louisiana Revised Statutes 46:437.3
• Operate: means to navigate or otherwise use a motorboat or vessel. See Louisiana Revised Statutes 34:851.2
• Order: means a final order imposed pursuant to an administrative adjudication. See Louisiana Revised Statutes 46:437.3
• Owner: means a person, other than a lien holder, having a property interest in or title to a motorboat. See Louisiana Revised Statutes 34:851.2
• Ownership interest: means the possession, directly or indirectly, of equity in the capital or the stock, or the right to share in the profits, of a health care provider. See Louisiana Revised Statutes 46:437.3
• Participant: means a recipient of SNAP benefits who participates in the pilot initiative provided for in this Subpart. See Louisiana Revised Statutes 46:322
• Payment: means the payment to a health care provider from medical assistance programs funds pursuant to a claim, or the attempt to seek payment for a claim. See Louisiana Revised Statutes 46:437.3
• Person: means an individual, partnership, firm, corporation, association, or other entity. See Louisiana Revised Statutes 34:851.2
• Pilot initiative: means the workforce training and education pilot initiative provided for in this Subpart. See Louisiana Revised Statutes 46:322
• Plaintiff: The person who files the complaint in a civil lawsuit.
• Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court.
• Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
• Prohibited zone: means an area paralleling each side of the entire length of the Lake Pontchartrain Causeway Bridge and extending outward for a distance of one mile from both the most easterly and westerly outboard sides of the causeway bridge twin spans. See Louisiana Revised Statutes 34:851.2
• Property: means any and all property, movable and immovable, corporeal and incorporeal. See Louisiana Revised Statutes 46:437.3
• Provider: means any healthcare entity enrolled with the department as a provider in the Medicaid program. See Louisiana Revised Statutes 46:440.12
• Provider agreement: means a document which is required as a condition of enrollment or participation as a health care provider under the medical assistance programs. See Louisiana Revised Statutes 46:437.3
• Provider-in-fact: means an agent who directly or indirectly participates in management decisions, has an ownership interest in the health care provider, or other persons defined as a provider-in-fact by federal or state law or by rule. See Louisiana Revised Statutes 46:437.3
• Recipient: means an individual who is eligible to receive health care through the medical assistance programs. See Louisiana Revised Statutes 46:437.3
• Recoupment: means recovery through the reduction, in whole or in part, of payment to a health care provider. See Louisiana Revised Statutes 46:437.3
• Recovery: means the recovery of overpayments, damages, fines, penalties, costs, expenses, restitution, attorney fees, or interest or settlement amounts. See Louisiana Revised Statutes 46:437.3
• Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
• Rule: means any rule or regulation promulgated by the department in accordance with the Administrative Procedure Act and any federal rule or regulation promulgated by the federal government in accordance with federal law. See Louisiana Revised Statutes 46:437.3
• Sailboat: means any watercraft propelled by sail or canvas. See Louisiana Revised Statutes 34:851.2
• Sanction: shall include but is not limited to any or all of the following:

              (a) Recoupment. See Louisiana Revised Statutes 46:437.3

• Secretary: means the secretary of the Louisiana Department of Health, or his authorized designee. See Louisiana Revised Statutes 46:437.3
• Secretary: means the secretary of the Department of Wildlife and Fisheries. See Louisiana Revised Statutes 34:851.2
• Secretary or attorney general: means that either party is authorized to institute a proceeding or take other authorized action as provided in this Part pursuant to a memorandum of understanding between the two so as to notify the public as to whether the secretary or the attorney general is the deciding or controlling party in the proceeding or other authorized matter. See Louisiana Revised Statutes 46:437.3
• SNAP: means the Supplemental Nutrition Assistance Program administered at the federal level by the Food and Nutrition Service of the United States Department of Agriculture and at the state level by the Louisiana Department of Children and Family Services. See Louisiana Revised Statutes 46:322
• Statute: A law passed by a legislature.
• Temporary restraining order: Prohibits a person from an action that is likely to cause irreparable harm. This differs from an injunction in that it may be granted immediately, without notice to the opposing party, and without a hearing. It is intended to last only until a hearing can be held.
• Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
• Vessel: means watercraft and air boats of every description, other than a seaplane on the water, used or capable of being used as a means of transportation on water. See Louisiana Revised Statutes 34:851.2
• Watercraft: means any contrivance used or designated for navigation on water. See Louisiana Revised Statutes 34:851.2
• Waters of the state: means any waters within the territorial limits of this state and the marginal sea adjacent to this state and the high seas when navigated as a part of a journey or ride to or from the shore of this state. See Louisiana Revised Statutes 34:851.2
• Withhold payment: means to reduce or adjust the amount, in whole or in part, to be paid to a health care provider for a pending or future claim during the time of a criminal, civil, or departmental investigation or proceeding or claims review of the health care provider. See Louisiana Revised Statutes 46:437.3
• Writ: A formal written command, issued from the court, requiring the performance of a specific act.