SRC-SLL H.B. 1637 75(R)BILL ANALYSIS


Senate Research CenterH.B. 1637
By: Alvarado (Carona)
Health & Human Services
5-16-97
Committee Report (Amended)


DIGEST 

According to the U.S. General Accounting Office, health care fraud costs
American taxpayers about $100 billion each year.  Identified cases of
fraud include several incidents in which Medicaid providers intentionally
performed unnecessary procedures, such as crowning undamaged teeth, or
charging the state for services that were never rendered on children.
This bill will increase penalties for fraudulent or other unlawful acts
committed under the state Medicaid program that result in injury to a
child. 

PURPOSE

As proposed, H.B. 1637  increases penalties for fraudulent or other
unlawful acts committed under the state Medicaid program that result in
injury to a child. 

RULEMAKING AUTHORITY

Rulemaking authority is granted to the Health and Human Services
Commission or an agency operating part of the medical assistance program
in SECTION 1 (Section 32.039(s), Human Resources Code) and to the board of
a state agency that operates as part of the state Medicaid program in
SECTION 4 (Section 36.009(b), Human Resources Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Section 32.039, Human Resources Code, by amending
Subsection (b) and adding Subsection (s), to provide that a person who
presents or causes to be presented to the Health and Human Services
Commission or an agency operating part of the medical assistance program
(department) a claim that contains a statement or representation the
person knows to be false is liable to the department for a civil penalty
of not less than $5,000 or more than $15,000 for each item or service for
which payment was claimed if the false statement or representation results
in injury to certain persons; or not more than $2,000 for each item or
service for which payment was claimed if the false statement or
representation does not result in injury to a person described by
Paragraph (A).  Prohibits a person found liable under Subsection (b) for a
false statement or representation that resulted in injury to certain
persons from providing or arranging to provide health care services under
the medical assistance program for a period of 10 years.  Authorizes the
department, by rule, to provide for a period of ineligibility longer than
10 years.  Provides that the period of ineligibility begins on the date on
which the determination that the person is liable becomes final.  Provides
that this subsection does not apply to a person who operates a nursing
facility. 

SECTION 2. Amends Chapter 32B, Human Resources Code, by adding Section
32.047, Human Resources Code, as follows: 

Sec.  32.047.  PROHIBITION OF CERTAIN HEALTH CARE SERVICE PROVIDERS.
Provides that, under certain circumstances, a person is permanently
prohibited from providing or arranging to provide health care services
under the medical assistance program. 

SECTION 3. Amends Section 36.004(a), Human Resources Code, to make
conforming changes. 

SECTION 4. Amends Section 36.009, Human Resources Code, to require certain
persons to suspend or revoke a provider agreement between the department
or agency and a person, other than  a person who operates a nursing
facility, found liable under Section 36.004 and a permit, license, or
certification granted by the department or agency to a person, other than
a person who operates a nursing facility, found liable under Section
36.004.  Prohibits a person found liable under Section 36.004 from
providing or arranging to provide health care services under the state
Medicaid program for a period of 10 years.  Authorizes the board of a
state agency that operates part of the Medicaid program, by rule, to
provide for a period of ineligibility longer than 10 years.  Provides that
this subsection does not apply to a person who operates a nursing
facility.  Makes conforming changes. 

SECTION 5. Provides that if before implementing any provision of this Act,
the Health and Human Services Commission or other state agency determines
that a waiver or authorization from a federal agency is necessary for
implementation, the commission or other state agency shall request the
waiver or authorization and may delay implementing that provision until
the waiver or authorization is granted. 

SECTION 6. Makes application of this Act prospective.

SECTION 7. Effective date: September 1, 1997, but only if S.B. 30, Acts of
the 75th Legislature, Regular Session, 1997, does not become law. 

SECTION 8. Emergency clause.



SUMMARY OF COMMITTEE CHANGES

Amendment 1.

(1) On page 1, line 21, between "to" and "a", insert "an elderly person,
as defined by Section 48.002(1), a disabled person, as defined by Section
48.002(a)(A), or". 

(2) On page 2, lines 1 and 2, strike "younger than 18 years of age" and
substitute "described by Paragragh (A)". 

(3) On page 2, line 4, between "to" and "a", insert "an elderly person, as
defined by Section 48.002(1), a disabled person, as defined by Section
48.002(8)(A), or". 

(4) On page 2, line 10, immediately following the last sentence, insert
"This subsection does not apply to a person who operates a nursing
facility." 

(5) On page 2, line 12, strike "32.043" and substitute "32.047".

(6) On page 2, line 13, strike "32.043" and substitute "32.047".

(7) On page 2, line 19, between "to" and "a", insert "an elderly person,
as defined by Section 48.002(1), a disabled person, as defined by Section
48.002(8)(A), or". 

(8) On page 3, line 9, between "to" and "a", insert "an elderly person, as
defined by Section 48.002(1), a disabled person, as defined by Section
48.002(8)(A), or". 

(9) On page 3, line 12, strike "youner than 18 years of age" and
substitute "described by Paragraph (A)". 

(10) On page 3, line 25, between "person" and "found", insert ", other
than a person who operates a nursing facility,". 

(11) On page 3, lines 25-27, strike "for an unlawful act that resulted in
injury to a person youner than 18 years of age". 

(12) On page 4, line 2, between "person" and "found", insert ", other than
a person who  operates a nursing facility,". 

(13) On page 4, lines 3 and 4, strike "for an unlawful act that resulted
in injury to a person youner than 18 years of age". 

(14) On page 4, line 7, between "person" and "found", insert "who operates
a nursing facility". 

(15) On page 4, lines 8 and 9, strike "for an unlawful act that does not
result in injury to a person younger than 18 years of age". 

(16) On page 4, lines 11, between "person" and "found", insert "who
operates a nursing facility". 

(17) On page 4, lines 12 and 13, strike "for an unlawful act that does not
result in injury to a person younger than 18 years of age". 

(18) On page 4, lines 14 and 15, strike "that resulted in injury to a
person younger than 18 years of age". 

(19) On page 4, line 18, strike "part of the state" and substitute "part
of the". 

(20) On pge 4, line 22, immediately following the last sentence, insert
"This subsection does not apply to a person who operates a nursing
facility." 

(21) On page 5, line 15, between "1997" and the period, insert ", but only
if S.B. No. 30, Acts of the 75th Legislature, Regular Session, 1997, does
not become law".