Louisiana Revised Statutes 22:1260.9 – A. In addition to the penalties and other enforcement provisions of this Subpart, any person who willfully violates the provisions of this Subpart shall be subject to civil penalties
Terms Used In Louisiana Revised Statutes 22:1260.9
- Conviction: A judgement of guilt against a criminal defendant.
- Discount medical plan: shall mean a business arrangement or contract in which a person, in exchange for fees, dues, charges or other valuable consideration, provides access for plan members to providers of medical services and the right to receive medical services from those providers at a discount. See Louisiana Revised Statutes 22:1260.2
- Discount medical plan organization: shall mean any person or organization that operates a discount medical plan and contracts with providers, provider networks or other discount medical plan organizations to offer access to medical services at a discount and determines the charge to discount medical plan members. See Louisiana Revised Statutes 22:1260.2
- Fraud: Intentional deception resulting in injury to another.
- Marketer: shall mean any person who markets, promotes, sells or distributes a discount medical plan, including but not limited to a private label entity that places its name on and markets or distributes a discount medical plan. See Louisiana Revised Statutes 22:1260.2
- Person: shall mean an individual or an entity. See Louisiana Revised Statutes 22:1260.2
- Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
A. In addition to the penalties and other enforcement provisions of this Subpart, any person who willfully violates the provisions of this Subpart shall be subject to civil penalties of up to two thousand five hundred dollars per violation.
B. A person that willfully operates as or aids and abets another person’s operating as a discount medical plan organization in violation of La. Rev. Stat. 22:2397(B) commits insurance fraud and shall be subject to payment of a monetary penalty of not more than one thousand dollars for each and every act or violation, but not to exceed one hundred thousand dollars, unless the person knew or reasonably should have known he was in violation of La. Rev. Stat. 22:2397(B), in which case the penalty shall not be more than twenty-five thousand dollars for each and every violation not to exceed an aggregate penalty of two hundred-fifty thousand dollars in any six-month period, as if the unregistered discount medical plan organization were an unauthorized insurer, and the fees, dues, charges or other consideration collected from the members by the unregistered discount medical plan organization or marketer were insurance premium.
C. A person that collects fees for purported membership in a discount medical plan, but purposefully fails to provide the promised benefits commits a theft and upon conviction is subject to the criminal penalties for theft enumerated in La. Rev. Stat. 14:67. In addition, upon conviction, the person shall be ordered to pay restitution to persons aggrieved by the violation of this Subpart. Restitution shall be ordered in addition to a fine or imprisonment, but not in lieu of a fine or imprisonment.
Acts 2008, No. 442, §1, eff. Jan. 1, 2009; Redesignated by Acts 2009, No. 503, §3.