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A BILL TO BE ENTITLED
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AN ACT
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relating to the retention by a managed care organization of certain |
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money recovered as a result of a fraud or abuse investigation under |
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Medicaid or the child health plan program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 531.1131(c-1), Government Code, is |
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amended to read as follows: |
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(c-1) If the commission's office of inspector general |
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notifies a managed care organization under Subsection (b), proceeds |
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with recovery efforts, and recovers all or part of the payments the |
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organization identified as required by Subsection (a)(1), the |
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organization is entitled to one-half of the amount recovered for |
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each payment the organization identified [after any applicable |
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federal share is deducted. The organization may not receive more |
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than one-half of the total amount of money recovered after any |
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applicable federal share is deducted]. |
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SECTION 2. Section 531.1131(c-1), Government Code, as |
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amended by this Act, applies only to an amount of money recovered on |
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or after the effective date of this Act. An amount of money |
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recovered before the effective date of this Act is governed by the |
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law in effect immediately before that date, and that law is |
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continued in effect for that purpose. |
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SECTION 3. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 4. This Act takes effect September 1, 2023. |