La. Admin. Code tit. 46 § LI-111

Current through Register Vol. 50, No. 11, November 20, 2024

Section LI-111 - Prohibition of Fee Splitting

A. An optometrist, duly licensed under the provisions of the Louisiana optometry law as set forth in R.S. 37:1041 et seq. shall not divide, share, split, or allocate, either directly or indirectly, any fee for optometric services or materials with any person, corporation, partnership, or other entity, other than through an affiliation with:

1. a professional optometric corporation or professional medical corporation organized pursuant to title 12 of the Louisiana Revised Statutes and domiciled in the state of Louisiana;

2. a partnership or limited liability company domiciled in the state of Louisiana and for whom each partner or member, as the case may be, is:

a. an optometrist or physician duly licensed as an optometrist or physician in the state of Louisiana; or

b. a professional optometric corporation or professional medical corporation described above in Paragraph A.1 of this Section;

3. an optometrist or physician duly licensed as an optometrist or physician in the state of Louisiana;

4. a licensed hospital or hospital affiliate;

5. a licensed ambulatory surgical center owned in full or in part by Louisiana-licensed physicians or optometrists;

6. a government sponsored healthcare program or facility;

7. an entity that is a combination or joint venture of the entities authorized under this §111 A

B. Nothing contained in this Section prohibits an optometrist from paying:

1. an employee in the regular course of employment; or

2. a fair market value fee to a person or entity organized and operated for the primary purpose of providing billing services, collection services, administrative preparation, practice management, marketing materials, cooperative buying and/or group purchasing options for or on behalf of an optometrist or entity described above in §111.A based upon a percentage of professional service fees billed or collected, a flat fee, or any other arrangement that directly or indirectly divides professional fees, so long as:

a. the optometrist at all times controls the amount of the fees charged and collected for professional services;

b. the fee paid to the service provider is not for the solicitation or referral of a patient; and

c. no significant function of the service provider involves activities other than the provision of billing services, collection services, administrative preparation, practice management, marketing materials, cooperative buying and/or group purchasing options.

C. Nothing in this Section shall be construed as to prohibit a licensed optometrist from participating in a government-approved shared savings or alternative payment model such as an accountable care organization, physician specialty model, or Medicare Advantage innovation model.

D. Violation of the provisions of this §111 by an optometrist shall be considered a violation of provisions of R.S. 37:1061, and as such the board may refuse to renew the license of any such optometrist on its annual renewal date of March 1 of each year (R.S. 37:1056) and/or subject such optometrist to suspension or revocation of his or her license to practice optometry upon due notice and hearing as provided in R.S. 37:1062.

La. Admin. Code tit. 46, § LI-111

Promulgated by the Department of Health and Hospitals, Board of Optometry Examiners, LR 32:630 (April 2006), Amended by the Department of Health, Board of Optometry Examiners, LR 441247 (7/1/2018).

AUTHORITY NOTE: Promulgated in accordance with R.S. 37:1048.