RS 46:460.87: Penalties

A managed care organization found by the secretary to be in violation of any provision of this Subpart may be subject to a penalty of up to twenty-five thousand dollars per violation. In addition, if a managed care organization is subject to more than one hundred independent reviews annually and the percentage of adverse determinations overturned in favor of the healthcare provider as a result of an independent review is greater than twenty-five percent, the managed care organization may be subject to a penalty of up to twenty-five thousand dollars.