Terms Used In Louisiana Revised Statutes > Title 33 > Chapter 13 - Property and Buildings

• Activity statement: means any written communication from a health care provider that advises an enrollee or insured of covered health care services that have been billed to a health insurance issuer. See Louisiana Revised Statutes 22:1872
• Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
• 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.
• Base health care facility: means a facility or institution providing health care services, including but not limited to a hospital or other licensed inpatient center, ambulatory surgical or treatment center, skilled nursing facility, inpatient hospice facility, residential treatment center, diagnostic, laboratory, or imaging center, or rehabilitation or other therapeutic health setting that has entered into a contract or agreement with a facility-based physician. See Louisiana Revised Statutes 22:1872
• 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}
• Bill: means any written or electronic communication that sets forth the amount owed by an enrollee or insured. See Louisiana Revised Statutes 22:1872
• Child: means a person who has not reached age eighteen or otherwise been legally emancipated. See Louisiana Revised Statutes 17:407.33
• Child: means a person who has not reached the age of eighteen years. See Louisiana Revised Statutes 17:407.62
• Child and Adult Care Food Program: means the federal nutrition reimbursement program as funded by the United States Department of Agriculture through the state Department of Education. See Louisiana Revised Statutes 17:407.62
• Child Care and Development Fund: means the child care programs funded through the federal Child Care and Development Fund Block Grant Act and administered by the state Department of Education. See Louisiana Revised Statutes 17:407.62
• Child day care center: means any place or facility operated by any institution, political subdivision, society, agency, corporation, person or persons, or any other group for the purpose of providing care, supervision, and guidance of seven or more children, not including those related to the caregiver, unaccompanied by parent or legal custodian, on a regular basis for at least twelve and one-half hours in a continuous seven-day week. See Louisiana Revised Statutes 17:407.33
• Commission: means the Louisiana Workforce Commission. See Louisiana Revised Statutes 23:1
• Commissioner: means the commissioner of insurance. See Louisiana Revised Statutes 22:1872
• Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
• Consolidated activity statement and bill: means any written or electronic communication from a health care provider that advises an enrollee or insured of covered health care services that have been billed to a health insurance issuer and which sets forth an amount owed by an enrollee or insured. See Louisiana Revised Statutes 22:1872
• Contracted health care provider: means a health care provider that has entered into a contract or agreement directly with a health insurance issuer or with a health insurance issuer through a network of providers for the provision of covered health care services. See Louisiana Revised Statutes 22:1872
• Contracted reimbursement rate: means the aggregate maximum amount that a contracted health care provider has agreed to accept from all sources for provision of covered health care services under the health insurance coverage applicable to the enrollee or insured. See Louisiana Revised Statutes 22:1872
• Covered health care services: means services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease that are either covered and payable under the terms of health insurance coverage or required by law to be covered. See Louisiana Revised Statutes 22:1872
• Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
• Deed: The legal instrument used to transfer title in real property from one person to another.
• Department: means the state Department of Education. See Louisiana Revised Statutes 17:407.33
• Department: means the state Department of Education. See Louisiana Revised Statutes 17:407.62
• Discount billing: means any written or electronic communication issued by a contracted health care provider that appears to attempt to collect from an enrollee or insured an amount in excess of the contracted reimbursement rate for covered services. See Louisiana Revised Statutes 22:1872
• Donor: The person who makes a gift.
• Dual billing: means any written or electronic communication issued by a contracted health care provider that sets forth any amount owed by an enrollee or insured that is a health insurance issuer liability. See Louisiana Revised Statutes 22:1872
• Early learning center: means any child day care center, Early Head Start Center, Head Start Center, or stand-alone prekindergarten program not attached to a school. See Louisiana Revised Statutes 17:407.33
• Ex officio: Literally, by virtue of one's office.
• Explanation of benefits: means any written communication clearly identified as issued by the health insurance issuer or its agent that contains information regarding coverage, payment, or other information regarding current status of a claim submitted to the health insurance issuer or its agent. See Louisiana Revised Statutes 22:1872
• Facility-based physician: means a physician licensed to practice medicine who is required by the base health facility to provide services in a base health care facility as an anesthesiologist, hospitalist, intensivist, neonatologist, pathologist, radiologist, emergency room physician, or other on-call physician who is required by the base health care to provide covered health care services related to an emergency medical condition as defined in La. See Louisiana Revised Statutes 22:1872
• 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.
• Family child care provider: means an individual who provides child care services for fewer than twenty-four hours per day per child, as the sole caregiver, for six or fewer children, in a private residence. See Louisiana Revised Statutes 17:407.62
• 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.
• Fraud: Intentional deception resulting in injury to another.
• Grantor: The person who establishes a trust and places property into it.
• 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 care facility: means a facility or institution providing health care services including but not limited to a hospital or other licensed inpatient center, ambulatory surgical or treatment center, skilled nursing facility, inpatient hospice facility, residential treatment center, diagnostic, laboratory, or imaging center, or rehabilitation or other therapeutic health setting. See Louisiana Revised Statutes 22:1872
• Health care professional: means a physician or other health care practitioner licensed, certified, or registered to perform specified health care services consistent with state law. See Louisiana Revised Statutes 22:1872
• Health care services: means services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease. See Louisiana Revised Statutes 22:1872
• Health insurance coverage: means benefits consisting of medical care provided or arranged for directly, through insurance or reimbursement, or otherwise, and includes health care services paid for under any plan, policy, or certificate of insurance. See Louisiana Revised Statutes 22:1872
• Health insurance issuer: means any entity that offers health insurance coverage through a policy or certificate of insurance subject to state law that regulates the business of insurance. See Louisiana Revised Statutes 22:1872
• Health insurance issuer liability: means the contractual liability of a health insurance issuer for covered health care services pursuant to the plan or policy provisions between the enrollee or insured and the health insurance issuer. See Louisiana Revised Statutes 22:1872
• In-home provider: means an individual who provides child care services in the child or children's own home. See Louisiana Revised Statutes 17:407.62
• insured: means a person who is enrolled in or insured by a health insurance issuer for health insurance coverage. See Louisiana Revised Statutes 22:1872
• Legatee: A beneficiary of a decedent
• License type: means the type of license applied for or held, which shall include Type I, Type II, and Type III. See Louisiana Revised Statutes 17:407.33
• network: means an entity other than a health insurance issuer that, through contracts with health care providers, provides or arranges for access by groups of enrollees or insureds to health care services by health care providers who are not otherwise or individually contracted directly with a health insurance issuer. See Louisiana Revised Statutes 22:1872
• 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: 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.
• Office: means the office of state fire marshal. See Louisiana Revised Statutes 17:407.62
• Original bill: A bill which is drafted by a committee. It is introduced by the committee or subcommittee chairman after the committee votes to report it.
• Pharmacy: means any appropriately licensed place where prescription drugs are dispensed as defined in La. See Louisiana Revised Statutes 22:1863
• Pharmacy benefit manager: means an entity that administers or manages a pharmacy benefits plan or program. See Louisiana Revised Statutes 22:1863
• Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government.
• provider: means a health care professional or a health care facility or the agent or assignee of such professional or facility. See Louisiana Revised Statutes 22:1872
• Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
• related: means the child, grandchild, niece, or nephew of the primary child care provider of a family child care provider or in-home provider. See Louisiana Revised Statutes 17:407.62
• relative: means a natural or adopted child or grandchild of the caregiver or a child in the legal custody of the caregiver. See Louisiana Revised Statutes 17:407.33
• Secretary: means the secretary of the commission. See Louisiana Revised Statutes 23:1
• Sponsoring organization: means a public or nonprofit private organization that is recognized by the department and that is entirely responsible for the administration of the Child and Adult Care Food Program for a provider. See Louisiana Revised Statutes 17:407.62
• Spread pricing: means any amount a pharmacy benefit manager charges or claims from a health plan provider or managed care organization for payment of a prescription or for pharmacy services that is different than the amount the pharmacy benefit manager paid to the pharmacist or pharmacy who filled the prescription or provided the pharmacy services. See Louisiana Revised Statutes 22:1863
• 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.
• Trustee: A person or institution holding and administering property in trust.
• Venue: The geographical location in which a case is tried.