Terms Used In Louisiana Revised Statutes > Title 22 > Chapter 6 > Part II > Subpart C - Pharmacy and Pharmacist Claims

• Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
• 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.
• Appropriate early childhood program: means a developmentally appropriate program for young children, ages three to five years, which is in compliance with regulatory guidelines to be issued by the department pursuant to this Part and which is approved by the State Board of Elementary and Secondary Education. See Louisiana Revised Statutes 17:407.1
• Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. ^{Source: OCC}
• Claim: means a request by a pharmacist for payment by a health insurance issuer. See Louisiana Revised Statutes 22:1852
• Commissioner: means the commissioner of insurance. See Louisiana Revised Statutes 22:1852
• Continuance: Putting off of a hearing ot trial until a later time.
• Contract: A legal written agreement that becomes binding when signed.
• Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
• Department: means the Department of Insurance. See Louisiana Revised Statutes 22:1852
• Department: means the state Department of Education. See Louisiana Revised Statutes 17:407.1
• Electronic claim: means the transmission of data for purposes of payment of covered prescription drugs, other products and supplies, and pharmacist services in an electronic data format specified by a health insurance issuer and approved by the department. See Louisiana Revised Statutes 22:1852
• Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
• expansion project: means a project or projects for the acquisition, construction, installation, and equipping of additions or improvements to the Ernest N. See Louisiana Revised Statutes 33:4710.24
• Fiduciary: A trustee, executor, or administrator.
• Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
• food service establishment: has the meaning set forth in La. See Louisiana Revised Statutes 33:4710.24
• Fraud: Intentional deception resulting in injury to another.
• Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
• Health insurance coverage: means benefits consisting of prescription drugs, other products and supplies, and pharmacist services provided directly, through insurance or reimbursement, or otherwise and including items and services paid for as prescription drugs, other products and supplies, and pharmacist services under any hospital or medical service policy or certificate, hospital or medical service plan contract, preferred provider organization agreement, or health maintenance organization contract offered by a health insurance issuer. See Louisiana Revised Statutes 22:1852
• Health insurance issuer: means an insurance company, including a health maintenance organization as defined and licensed pursuant to Subpart I of Part I of Chapter 2 of this Title, unless preempted as an employee benefit plan under the Employee Retirement Income Security Act of 1974. See Louisiana Revised Statutes 22:1852
• HIPPY: means the Home Instruction Program for Preschool Youngsters. See Louisiana Revised Statutes 17:407.1
• hotel: as used in this Chapter means and includes any establishment that is engaged in the business of furnishing or providing rooms intended or designed for dwelling, lodging, or sleeping purposes to transient guests and that consists of ten or more guest rooms. See Louisiana Revised Statutes 33:4710.15
• insured: means an individual who is enrolled or insured by a health insurance issuer for health insurance coverage. See Louisiana Revised Statutes 22:1852
• 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.
• Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). ^{Source: OCC}
• Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
• Lien: A claim against real or personal property in satisfaction of a debt.
• Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
• Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• person: includes a body of persons, whether incorporated or not. See Louisiana Revised Statutes 1:10
• Person: as used in this Chapter shall have the same definition as that contained in La. See Louisiana Revised Statutes 33:4710.15
• pharmacies: means any appropriately licensed place within this state where prescription drugs are dispensed and pharmacist services are provided and any place outside of this state where prescription drugs are dispensed and pharmacist services are provided to residents of this state. See Louisiana Revised Statutes 22:1852
• Pharmacist: means an individual currently licensed as a pharmacist by the Louisiana Board of Pharmacy to engage in the practice of pharmacy in this state. See Louisiana Revised Statutes 22:1852
• Pharmacist services: means the filling and dispensing of prescription drugs or providing products and supplies, drug therapy, and other patient care services provided by a licensed pharmacist with the intent of achieving outcomes related to the cure, prevention, or management of a disease, elimination or reduction of patient's symptoms, or arresting or slowing of a disease process. See Louisiana Revised Statutes 22:1852
• projects: means one or more of any combination of convention, exhibition, and tourist facilities, including a convention center hotel with a multi-story parking garage and bridge connecting the hotel and the south end of the convention center, the "Convention Center Headquarters Hotel Project" and the necessary land, acquired by lease or purchase, site improvements, infrastructure, furnishings, machinery, equipment, and appurtenances for any such facility. See Louisiana Revised Statutes 33:4710.11
• Remittance advice: means a written or electronic communication explaining the health insurance issuer's action on each claim adjudicated by the issuer. See Louisiana Revised Statutes 22:1852
• Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.
• Trustee: A person or institution holding and administering property in trust.
• Uniform claim form: shall mean a form prescribed by rule by the department pursuant to La. See Louisiana Revised Statutes 22:1852