SRC-CDH S.B. 30 75(R)   BILL ANALYSIS


Senate Research Center   S.B. 30
By: Zaffirini
Health & Human Services
3-31-97
As Filed


DIGEST 

Texas spent more than $7.3 billion for Medicaid services and $1.3 billion
on financial assistance and food stamp programs in fiscal year 1995, yet
fraud may account for as much as 10 percent of all Medicaid, financial
assistance, and food stamp claims.  Even if Texas loses only a fraction of
this amount to fraud, the loss represents a serious, ongoing drain of
public resources.  Successful fraud control efforts demand strong referral
and detection programs, an effective investigative function, and
appropriate punishments. 

This legislation provides a package of reforms intended to improve the
state's ability to combat fraudulent acts committed against publicly
funded programs.  This bill will centralize and streamline fraud referral,
investigation, and prosecution efforts under the Health and Human Services
Commission's newly-created Office of Investigations and Enforcement;
ensure appropriate use of Medicaid-funded services and equipment; tighten
provider enrollment processes through the use of background checks and
on-site inspections; require health and human services agencies to use
advanced fraud-detection technologies based on the success of the
comptroller's Medicaid Fraud Detection project; add a state qui tam cause
of action to prosecute fraudulent Medicaid providers; provide additional
controls for fraud and abuse in Medicaid managed care; and enact stiffer
penalties for fraud, especially for those acts of fraud that harm
children.      

PURPOSE

As proposed, S.B. 30 establishes fraud and improper payments under the
state Medicaid program and other programs, and creates a criminal offense
of Medicaid fraud while providing penalties. 

RULEMAKING AUTHORITY

Rulemaking authority is granted to the Department of Human Services in
SECTIONS 1.01, 2.012.04, 3.01, 3.02, and 5.01 (Sections 22.0254(d),
32.024(t), 32.024(u), 32.0321(a), 32.0322(b), 32.039(u) and (v),
32.046(a), and 23.016, Human Resources Code); to the Health and Human
Services Commission (HHSC) in SECTION 1.04 (Section 531.047(a), Government
Code) and SECTION 2.07(a); to the secretary of state in SECTION 1.06(c);
to HHSC and each agency operating part of the state Medicaid program in
SECTION 2.08(c); and to the board of a state agency that operates part of
the Medicaid program in SECTION 4.06 (Section 36.005(b), Human Resources
Code) of this bill. 

SECTION BY SECTION ANALYSIS

ARTICLE 1.  GENERAL PROVISIONS RELATING TO WELFARE AGENCIES

SECTION 1.01.  COLLECTION OF FOOD STAMP AND FINANCIAL ASSISTANCE PAYMENTS
MADE IN ERROR.  (a)  Amends Chapter 22, Human Resources Code, by adding
Sections 22.0251-22.0252, as follows: 

Sec. 22.0251.  TIMELY DETERMINATION OF ERRORS.  Requires the Texas
Department of Human Services (department), subject to the approval of the
commissioner of health and human services (commissioner), to record the
time taken to discover an error in making a grant; set progressive goals
for reducing the discovery time; and adopt a schedule to meet the goals
set.  Sets forth the terms under which the department is  required to
submit a progress report. 
 
Sec. 22.0252.  TELEPHONE COLLECTION PROGRAM.  Sets forth the terms by
which the department is required to use the telephone to collect
reimbursement from a person who receives a benefit granted in error, and
submit a semiannual report. 

Sec. 22.0253.  PARTICIPATION IN FEDERAL TAX REFUND OFFSET PROGRAM.
Requires the department to participate in the Federal Tax Refund Offset
Program to attempt to recover benefits granted in error, and submit as
many claims as possible for offset against income tax returns.   

Sec. 22.0254.  PROSECUTION OF FRAUDULENT CLAIMS.  Requires the department
to keep a record of the dispositions of referrals made by the department
to a district attorney concerning fraudulent claims for benefits.  Sets
forth the terms by which the department is required to obtain status
information on each major fraudulent claim; request a written explanation
for each case referred in which the district attorney declines to
prosecute; and encourage the creation of a special welfare fraud unit in
each district attorney's office.  Requires a district attorney to
cooperate in providing information requested by the department.  Requires
the department, by rule, to define what constitutes a major fraudulent
claim.    

(b)  Amends Chapter 22, Human Resources Code, by adding Section 22.0291,
as follows: 

Sec. 22.0291.  EMBASSY INFORMATION MATCHING SYSTEM.  Sets forth the terms
by which the department is required to use a computerized matching system
for the purpose of preventing individuals from unlawfully receiving
benefits administered by the department.  Sets forth the terms by which
the department is authorized to enter into an agreement with an embassy as
necessary to implement this section, and by which the department and
embassies are required to protect the confidentiality of shared
information.  Requires the department to submit a semiannual report.    

(c)  Requires the department to begin operation of the telephone
collection program not later than January 1, 1998. 

(d)  Requires the department to submit the initial reports required by
Sections 22.0251(b) and 22.0291(e), Human Resources Code, not later than
January 1, 1998. 

(e)  Requires the department to submit the initial report required by
Section 22.0252(b), Human Resources Code, not later than September 1,
1998. 

SECTION 1.02.  PAYMENT OF MEDICAID CLAIMS.  (a) Amends Chapter 32B, Human
Resources Code, by adding Sections 32.043 and 32.044, as follows: 

Sec. 32.043.  DUAL MEDICAID AND MEDICARE COVERAGE.  Requires the
department to identify each individual receiving dual Medicaid and
Medicare coverage, and to analyze claims to ensure that payment is not
made under the medical assistance program if the service is covered under
the Medicare program. 

Sec. 32.044.  MISDIRECTED BILLING.  Requires the department to develop a
procedure for matching claims to determine alternative responsibility for
payment and ensuring that the appropriate entity bears the cost. 

(b)  Sets forth the terms by which the Health and Human Services
Commission (HHSC) is required to submit an amendment to the state's
Medicaid plan authorizing the state to limit payment associated with a
service for a person entitled to both Medicaid and Medicare coverage.
Requires HHSC, on receipt of approval of the amendment, to ensure that the
payments are limited.   

SECTION 1.03.  ENHANCED MEDICAID REIMBURSEMENT.   (a)  Amends Chapter 32B,
Human Resources Code, by adding Section 32.045, as follows: 

Sec. 32.045.  ENHANCED REIMBURSEMENT.  Requires the department to develop
a procedure for identifying each service provided under the medical
assistance program for which the state is eligible to receive enhanced
reimbursement of costs from the federal government and ensuring that the
state seeks the highest level of federal reimbursement available. 

(b)  Requires the Texas Department of Health (TDH) to identify and seek
reimbursement for all services provided under the state Medicaid program
for a certain period for which the state was eligible but did not receive
enhanced reimbursement of costs at a certain rate. 

SECTION 1.04.  MINIMUM COLLECTION GOAL.  Amends Chapter 531B, Government
Code, by adding Section 531.047, as follows: 

Sec. 531.047.  MINIMUM COLLECTION GOAL.  Requires HHSC, by rule, to set a
minimum goal for the department specifying the amount of benefits granted
in error that the department should recover.  Sets forth the terms by
which the comptroller, if the department fails to meet the goal set under
Subsection (a), is required to reduce the department's general revenue
appropriations by a certain amount.  Requires HHSC, the governor, and the
Legislative Budget Board to monitor the department's performance, and
requires the department to cooperate by providing information on request. 

SECTION 1.05.  COMMISSION POWERS AND DUTIES RELATING TO WELFARE FRAUD. (a)
Amends Chapter 531, Government Code, by adding Subchapter C, as follows: 

SUBCHAPTER C.  MEDICAID AND OTHER WELFARE FRAUD, MISUSE, OR OVERCHARGES   

Sec. 531.101.  AWARD FOR REPORTING MEDICAID FRAUD, MISUSE, OR OVERCHARGES.
Sets forth the terms by which HHSC is authorized to grant an award to an
individual who reports activity constituting fraud, misuse of funds, or
overcharges; and  determine the amount of an award.  Provides that an
award under this section is subject to appropriation.  Sets forth the
procedure for payment of, and appropriation of money for, an award.  

Sec. 531.102.  INVESTIGATIONS AND ENFORCEMENT OFFICE.  Sets forth the
terms by which HHSC, through the office of investigations and enforcement,
is responsible for the investigation of fraud and the enforcement of state
law relating to the provision of health and human services.  Requires HHSC
to set certain objectives, priorities, and performance standards for the
office; and cross-train office staff to enable pursuit of priority
Medicaid and welfare fraud and abuse cases. 

Sec. 531.103.  INTERAGENCY COORDINATION.  Establishes the conditions under
which HHSC and the office of the attorney general are required to enter
into a memorandum of understanding to implement procedures for processing
cases of suspected fraud, waste, or abuse; and jointly prepare and submit
a report. 

Sec. 531.104.  ASSISTING INVESTIGATIONS BY ATTORNEY GENERAL.  Sets forth
the terms by which HHSC and the attorney general are required to execute a
memorandum of understanding under which HHSC shall provide investigative
support to the attorney general. 

Sec. 531.105.  FRAUD DETECTION TRAINING.  Establishes the conditions by
which HHSC is required to implement a program to provide annual training
in identifying cases of fraud, waste, or abuse.  Requires TDH and the
department, in cooperation with HHSC, to periodically set a goal of the
number of cases that each agency will attempt to identify and refer to
HHSC.  Requires HHSC to include goal-related information in the annual
report.   
 
Sec. 531.106.  LEARNING OR NEURAL NETWORK TECHNOLOGY.  Requires HHSC to
use learning or neural network technology to identify and deter fraud;
contract with a private or public entity to develop and implement the
technology; require certain health and human services agencies to
participate; maintain all information necessary to apply the technology to
claims data covering a two-year period; and refer cases identified by the
technology to the appropriate office. 

Sec. 531.107.  PUBLIC ASSISTANCE FRAUD OVERSIGHT TASK FORCE.  Provides
that the Public Assistance Fraud Oversight Task Force assists HHSC and the
office of investigations and enforcement in improving the efficiency of
fraud investigations and collections.  Sets forth the composition,
presiding officer, and meeting times of the task force.  Sets forth the
compensation for a member's service on the task force.  Establishes the
conditions under which the commission's office of investigations and
enforcement is required to provide certain information to the task force.

Sec. 531.108.  FRAUD PREVENTION.  Requires the office of investigations
and enforcement to compile and disseminate accurate information and
statistics relating to fraud prevention and certain post-fraud referrals.
Sets forth the terms by which HHSC is required to publicize successful
fraud prosecutions; establish a toll-free hotline; develop a
cost-effective method of identifying applicants for public assistance in
certain areas; verify automobile information used as eligibility criteria;
establish a computerized matching system to prevent an incarcerated
individual from illegally receiving benefits; and submit a semiannual
report.   

Sec. 531.109.  DISPOSITION OF FUNDS.  Sets forth the disposition of funds
under this subchapter. 

(b)  Sets forth the terms under which Section 531.104, Government Code,
takes effect.   

(c)  Sets forth the terms by which HHSC is required to award the contract
for the learning or neural network technology, and by which the contractor
is required to begin operations.  Sets forth the terms by which the
commissioner is required to enter into an interagency agreement and
execute a memorandum of understanding with the comptroller. 

(d)  Requires HHSC to submit the initial report required by Section
531.108(e) not later than September 1, 1997. 

(e)  Provides that this article, in adding Section 531.101, Government
Code, conforms to a change in law made by Section 1, Chapter 444, Acts of
the 74th Legislature, Regular Session, 1995. 

(f)  Repealer:  Section 16G, Article 4413(502), V.T.C.S., as added by
Section 1, Chapter 444, Acts of the 74th Legislature, Regular Session,
1997. 

(g)  Sets forth the terms by which this Act prevails over another Act of
the 75th Legislature. 

(h)  Repealer:  Section 21.0145, Human Resources Code (Public Assistance
Fraud Oversight Task Force) and Section 22.027, Human Resources Code
(Fraud Prevention). 

SECTION 1.06.  CONSOLIDATION OF INVESTIGATIONS STAFF.  Sets forth the
terms by which the powers, duties, programs, funds, contracts, records,
employees, and rules or forms adopted by the department's office of
inspector general or TDH's policy and analysis group are transferred to
HHSC.  Provides that the secretary of state is authorized to adopt rules
as necessary to expedite the implementation of this subsection.  Makes
application of this Act prospective regarding the consolidation of
investigations staff. 

SECTION 1.07. CONTINGENT INTERAGENCY AGREEMENT RELATING TO INVESTIGATIONS
STAFF.  Sets forth the terms by which, if HHSC and the affected agencies
do  not complete the transfers required, the commissioner is required to
enter into an interagency agreement and execute a memorandum of
understanding with the comptroller. 

SECTION 1.08.  USE OF PRIVATE COLLECTION AGENTS.  Sets forth the terms
under which the department, with assistance from the Council on
Competitive Government, is required to use private collections agents to
collect reimbursements for benefits granted in error, and submit a
progress and final report.  Requires the department to ensure that the
collection agents are engaged in work not later than March 1, 1998.  

SECTION 1.09.  EXPEDITED FOOD STAMP DELIVERY; IMPACT ON FRAUDULENT CLAIMS.
Establishes the conditions by which the department is required to conduct
a study to determine the impact of one-day screening and service delivery
requirements on the level of fraud in the food stamp program, and submit a
report. 

SECTION 1.10.  STUDY ON COLLECTION OF ERRONEOUS FOOD STAMP OR FINANCIAL
ASSISTANCE BENEFITS THROUGH LIENS OR WAGE GARNISHMENT.  Sets forth the
terms by which the department is required to conduct a study on collection
of erroneous food stamp or financial assistance benefits through liens or
wage garnishment, and submit a report.    

SECTION 1.11.  OPERATION RESTORE TRUST.  Requires HHSC and the office of
the attorney general to cooperate with entities in other state
participating in "Operation Restore Trust" and share information.  Defines
"Operation Restore Trust." 

ARTICLE 2.  MEDICAID SERVICE PROVIDERS

SECTION 2.01.  AUTHORIZATION FOR AMBULANCE SERVICES.  Amends Section
32.024, Human Resources Code, by adding Subsection (t), to establish the
conditions under which the department, by rule, is required to require a
physician, nursing facility, or other health care provider to obtain
authorization for non-emergency ambulance services.  Requires HHSC and
each appropriate health and human services agency to adopt these rules not
later than January 1, 1998. 

SECTION 2.02.  DURABLE MEDICAL EQUIPMENT.  Amends Section 32.024, Human
Resources Code, by adding Subsection (u), to require the department, by
rule, to require a health care provider who prescribes durable medical
equipment for a child who receives medical assistance to certify that the
child received the proper equipment, the equipment fit properly, and the
child received the proper information.  Sets forth the terms under which
the department is required to develop a form for use in making this
certification.  Requires HHSC and each appropriate health and human
services agency to adopt these rules not later than January 1, 1998.  

SECTION 2.03.  SURETY BOND.  Amends Chapter 32B, Human Resources Code, by
adding Section 32.0321, as follows: 

Sec. 32.0321.  SURETY BOND.  Authorizes the department, by rule, to
require each provider of medical assistance in a provider group that has
demonstrated significant potential for fraud or abuse to file a surety
bond.   

SECTION 2.04.  CRIMINAL HISTORY INFORMATION.  (a)  Amends Chapter 32B,
Human Resources Code, by adding Section 32.0322, as follows: 

Sec. 32.0322.  CRIMINAL HISTORY RECORD INFORMATION.  Authorizes the
department to obtain the criminal history record information relating to a
provider or a person applying to enroll as a provider.  Requires the
department, by rule, to establish criteria for revoking a provider's
enrollment or denying a person's application to enroll as a provider. 

(b)  Amends Chapter 411F, Government Code, by adding Section 411.132, as
follows: 

Sec. 411.132.  ACCESS TO CRIMINAL HISTORY RECORD INFORMATION; AGENCIES
OPERATING PART OF MEDICAL ASSISTANCE PROGRAM.  Provides  that HHSC or an
agency operating part of the medical assistance program is entitled to
obtain criminal history record information relating to a provider or a
person applying to enroll as a provider.  Prohibits such information from
being released or disclosed except in certain circumstances.   

SECTION 2.05.  DIRECTOR AND OFFICER LIABILITY.  (a) Amends Chapter 32B,
Human Resources Code, by adding Section 32.0323, as follows: 
 
Sec. 32.0323.  LIABILITY OF DIRECTORS AND OFFICERS OF CORPORATIONS. Sets
forth the liability of directors and officers of corporations if a
corporation is found liable for damages, penalties, or fines resulting
from an act of fraud or abuse.  Requires the department to include a
reference to such liability in certain agreements. 

(b)  Makes application of this Act prospective regarding corporate fraud
or abuse. 

SECTION 2.06.  MANAGED CARE ORGANIZATIONS.  (a)  Amends Section 16A,
Article 4413(502), V.T.C.S., by amending Subsection (n) and adding
Subsections (o)-(s), to  require a managed care organization that
contracts with HHSC to report information necessary to set rates, detect
fraud, and ensure quality of care; develop and submit a plan for
preventing, detecting, and reporting fraud and abuse;  include standard
provisions in each subcontract that affects the delivery of or payment of
Medicaid services; and submit the subcontract and annual disclosure
statements to HHSC.  Requires HHSC to require each contract to contain
certain provisions, and to audit each managed care organization that
contracts with HHSC.  Sets forth the terms by which an audited managed
care organization is responsible for paying the costs of the audit.
Establishes the conditions under which HHSC and the Texas Department of
Insurance are required to enter into a memorandum of understanding.   

(b)  Amends Chapter 532B, Government Code as added by the Act of the 75th
Legislature, Regular Session, 1997, by adding Sections 532.112 and
532.113, as follows: 

Sec. 532.112.  DUTIES OF MANAGED CARE ORGANIZATION; CONTRACTUAL
PROVISIONS.  Makes conforming changes. 

Sec. 532.113.  AUDITS; MEMORANDUM OF UNDERSTANDING.  Makes conforming
changes. 

(c)  Requires HHSC to develop guidelines applicable to a managed care
organization's plan for preventing, detecting, and reporting Medicaid
fraud not later than November 1, 1997. 

(d)  Makes application of this Act prospective to November 1, 1997
regarding a managed care organization that enters into a contract with
HHSC. 

(e)  Makes application of this Act prospective regarding a contract.  

(f)  Sets forth those conditions which do not have to be met by a managed
care organization that contracts with HHSC before the effective date of
this section. 

(g)  Requires a managed care organization that renews a contract or
subcontract after the effective date to include all provisions required by
this section. 

(h)  Sets forth the terms under which Subsection (a) takes effect.

(i)   Sets forth the terms under which Subsection (b) takes effect.  

SECTION 2.07.  PILOT PROGRAM; ON-SITE REVIEWS OF PROSPECTIVE PROVIDERS.
Sets forth the conditions under which HHSC shall, by rule, establish a
pilot program to reduce fraud by conducting on-site reviews of prospective
providers; may expand the program; and shall submit a report.  Provides
that this section expires September 1, 1999. 

 SECTION 2.08.  DEVELOPMENT OF NEW PROVIDER CONTRACT.  Sets forth the
terms by which HHSC is required to develop a new provider contract that
contains provisions designed to strengthen HHSC's ability to prevent
provider fraud.  Establishes the conditions by which HHSC and each agency
operating part of the state Medicaid program, by rule, is required to
require each provider who enrolled in the program before the effective
date of this Act to reenroll under the new contract.    

SECTION 2.09.  PREFERRED VENDOR FOR DURABLE MEDICAL EQUIPMENT.  Requires
HHSC to submit an amendment to the state's Medicaid plan authorizing TDH
to select and use a preferred vendor for the delivery of durable medical
equipment. 

SECTION 2.10.  REVIEW OF SERVICE PROVIDER BILLING PRACTICES.  Sets forth
the terms by which TDH is required to conduct an automated review of
service provider billing practices, and to require the entity that
administers the state Medicaid program to modify the entity's claims
processing, monitoring procedures, and computer technology to prevent
improper billing. 

ARTICLE 3.  ADMINISTRATIVE PENALTIES AND SANCTIONS RELATING TO MEDICAID
FRAUD 

SECTION 3.01.  ADMINISTRATIVE PENALTIES.  (a)  Amends Section 32.039,
Human Resources Code, as follows: 

Sec. 32.039.  New heading:  DAMAGES AND PENALTIES.  Defines "claim,"
"managed care organization," and "managed care plan."  Provides that a
person commits a violation if the person presents to the department a
claim that contains a statement or representation that the person knows to
be false; or is a managed care organization that fails to provide a
medically necessary and required health benefit or service, fails to
provide certain required information, or engages in a fraudulent activity
in connection with enrollment of, or marketing to, an individual eligible
for medical assistance.  Replaces all references to "false claim" with
"violation."  Sets forth the penalty for a violation under Subsection (b).
Sets forth the terms by which a person is required to file a petition for
judicial review, and may stay enforcement of the penalty.  Deletes the
existing provisions regarding judicial review.  Sets forth the terms by
which a person found liable for a violation under Subsection (c) is
prohibited from providing health care services for a certain period.
Authorizes the department, by rule, to provide for an extended period of
ineligibility.  

(b)  Makes application of this Act prospective regarding a violation.

SECTION 3.02.  SANCTIONS APPLICABLE TO VENDOR DRUG PROGRAM.  Amends
Chapter 32B, Human Resources Code, by adding Section 32.046, as follows: 

Sec. 32.046.  VENDOR DRUG PROGRAM; SANCTIONS AND PENALTIES.  Requires the
department to adopt rules governing sanctions and penalties that apply to
a provider in the vendor drug program who submits an improper claim for
reimbursement; and to notify each provider in the program that the
provider is subject to sanctions and penalties.   

SECTION 3.03.  PROHIBITION OF CERTAIN PERSONS CONVICTED OF FRAUD.  Amends
Chapter 32B, Human Resources Code, by adding Section 32.047, as follows: 

Sec. 32.047.  PROHIBITION OF CERTAIN HEALTH CARE SERVICE PROVIDERS. Sets
forth the terms under which a person is permanently prohibited from
providing or arranging to provide health care services. 

SECTION 3.04.  DEDUCTIONS FROM LOTTERY WINNINGS.  (a)  Amends Sections
466.407(a) and (c), Government Code, to require the executive director to
deduct a certain amount from the winnings of a person determined to be
delinquent in the payment of a tax or other money collected by the
comptroller, rather than the state treasurer; or delinquent in reimbursing
the department for a benefit granted in error. Includes the department
among the entities required to provide the  executive director with a
report of persons who have been determined to be delinquent.      

(b)  Requires the department to implement the change in law made by this
section not later than January 1, 1998.  Prohibits the department from
seeking recovery through lottery prize deduction of an amount of a benefit
granted in error to a person. 

(c)  Sets forth the terms by which the executive director of the Texas
Lottery Commission is required to deduct erroneous amounts from lottery
prizes.        

ARTICLE 4.  CIVIL REMEDIES RELATING TO MEDICAID FRAUD AND CREATION OF
CRIMINAL OFFENSE 

SECTION 4.01.  REDESIGNATION.  (a)  Amends Chapter 36, Human Resources
Code, by designating Sections 36.001, 36.002, and 36.007-36.012 as
Subchapter A; renumbering Sections 36.007-36.012 as Sections
36.003-36.008, respectively, and adding a subchapter heading, as follows: 

SUBCHAPTER A.  GENERAL PROVISIONS

(b)  Amends Chapter 36, Human Resources Code, by designating Sections
36.003-36.006 as Subchapter B, renumbering those sections as Sections
36.051-36.054, respectively, and adding a subchapter heading, as follows: 

SUBCHAPTER B.  ACTION BY ATTORNEY GENERAL

SECTION 4.02.  DEFINITIONS.  Amends Section 36.001, Human Resources Code,
by amending Subdivisions (5)-(11) and adding Subdivision (12), to define
"managed care organization" and to redefine "provider."  Makes conforming
changes.   

SECTION 4.03.  UNLAWFUL ACTS RELATING TO MANAGED CARE ORGANIZATION. Amends
Section 36.002, Human Resources Code, to set forth the terms by which a
managed care organization engages in unlawful acts.   

SECTION 4.04.  APPLICABLE PENALTIES AND CONFORMING AMENDMENT.  Amends
Section 36.004, Human Resources Code, as renumbered by this article as
Section 36.052, by amending Subsections (a) and (e), to make conforming
changes. 

SECTION 4.05.  CONFORMING AMENDMENT.  Amends Section 36.005, Human
Resources Code, as renumbered by this Act as Section 36.053, by amending
Subsection (b), to make a conforming change.   

SECTION 4.06.  ADDITIONAL SANCTIONS FOR MEDICAID FRAUD.  Amends Section
36.009, Human Resources Code, as renumbered by this article as Section
36.005, to establish the conditions under which certain provider
agreements, permits, licenses, and certifications are required and
authorized to be suspended or revoked for an unlawful act.  Sets forth the
terms by which a person found liable under Section 32.052 is prohibited
from providing health care services for a certain period. Authorizes the
board of a state agency that operates part of the Medicaid program, by
rule, to extend the ineligibility period longer than 10 years.     

SECTION 4.07.  USE OF MONEY RECOVERED.  Amends Section 36.012, Human
Resources Code, as renumbered by this article as Section 36.008, to
authorize the attorney general to retain a certain portion of money
recovered under this chapter for the administration of this chapter. 

SECTION 4.08.  AUTHORITY OF ATTORNEY GENERAL.  (a)  Amends Chapter 36B,
Human Resources Code, by adding Section 36.055, as follows: 

Sec. 36.055.  ATTORNEY GENERAL AS RELATOR IN FEDERAL ACTION. Establishes
the conditions under which the attorney general is authorized to bring an
action as relator regarding an act in connection with the Medicaid program
for which a person may be held liable.   
 
(b)  Sets forth the terms by which the attorney general is required to
develop strategies to increase state recoveries and report the results of
the office's effort to the legislature. 

SECTION 4.09.  CIVIL ACTION BY PRIVATE PERSON FOR MEDICAID FRAUD.  Amends
Chapter 36, Human Resources Code, by adding Subchapter C, as follows: 

SUBCHAPTER C.  ACTION BY PRIVATE PERSONS

Sec. 36.101.  ACTION BY PRIVATE PERSON AUTHORIZED.  Sets forth the terms
by which a person is authorized to bring a civil action for a violation of
Section 36.002 for the person and the state in the name of the state.  

Sec. 36.102.  INITIATION OF ACTION.  Sets forth the terms by which a
person is required to initiate an action under this subchapter. 

Sec. 36.103.  ANSWER BY DEFENDANT.  Sets forth the terms by which a
defendant is required to file an answer to a petition.   

Sec. 36.104.  STATE'S DECISION TO CONTINUE ACTION.  Requires the state to
proceed with the action or notify the court that the state declines to
take over the action by a certain date.        

Sec. 36.105.  REPRESENTATION OF STATE BY PRIVATE ATTORNEY.  Authorizes the
attorney general to contract with a private attorney to represent the
state in an action. 

Sec. 36.106.  INTERVENTION BY OTHER PARTIES PROHIBITED.  Prohibits a
person other than the state from intervening or bringing a related action
based on the facts underlying a pending action. 

Sec. 36.107.  RIGHTS OF PARTIES IF STATE CONTINUES ACTION.  Sets forth the
rights of the parties to an action if the state proceeds with the action.

Sec. 36.108.  RIGHTS OF PARTIES IF STATE DOES NOT CONTINUE ACTION.  Sets
forth the rights of the parties to an action if the state elects not to
proceed with the action.   

Sec. 36.109.  STAY OF CERTAIN DISCOVERY.  Sets forth the terms by which
the court is authorized to stay the discovery for a certain period under
certain circumstances.   

Sec. 36.110.  PURSUIT OF ALTERNATE REMEDY BY STATE.  Authorizes the state
to pursue the state's claim through any alternate remedy available to the
state, notwithstanding Section 36.101.  Establishes the rights of the
person bringing the action if an alternate remedy is pursued in another
proceeding.  Sets forth the terms under which a finding of fact or
conclusion of law is final and conclusive. 

Sec. 36.111.  AWARD TO PRIVATE PLAINTIFF.  Sets forth the terms by which
the person bringing an action or settling a claim is entitled to an award
in a certain amount; and by which the court is authorized to award a
certain amount.  Defines "proceeds of the action."    
Sec. 36.112.  REDUCTION OF AWARD.  Sets forth the terms by which the court
may reduce the share of the proceeds of an action the person would
otherwise receive under Section 36.111, and is required to dismiss the
person from the civil action, under certain circumstances.  Prohibits the
person from receiving any share of the proceeds in certain situations.   

Sec. 36.113.  AWARD TO DEFENDANT FOR FRIVOLOUS ACTION OR ACTION BROUGHT
FOR PURPOSES OF HARASSMENT.  Establishes the conditions under which the
court is authorized to award the defendant reasonable attorney's fees and
expenses if the defendant prevails in the action and the court finds that
the claim was frivolous, vexatious,  or brought for purposes of
harassment.  Provides that Chapter 105, Civil Practice and Remedies Code,
applies in an action with which the state proceeds. 

Sec. 36.114.  CERTAIN ACTIONS BARRED.  Prohibits a person from bringing an
action under certain circumstances.  Defines "original source." 

Sec. 36.115.  STATE NOT LIABLE FOR CERTAIN EXPENSES.  Provides that the
state is not liable for expenses that a person incurs in bringing an
action under this section.   

Sec. 36.116.  RETALIATION BY EMPLOYER AGAINST PERSON BRINGING SUIT
PROHIBITED.  Establishes the terms by which a person who is discharged,
demoted, suspended, harassed, or discriminated against by the person's
employer because of a lawful act taken by the person in furtherance of an
action under this subchapter is entitled to reinstatement with the same
seniority status and a certain amount of back pay and compensation.
Authorizes a person to bring an action for the relief provided in this
section.  
SECTION 4.10.  CRIMINAL OFFENSE AND REVOCATION OF CERTAIN LICENSES.  (a)
Amends Chapter 36, Human Resources Code, by adding Subchapter D, as
follows: 

SUBCHAPTER D.  CRIMINAL PENALTIES

Sec. 36.131.  CRIMINAL OFFENSE.  Provides that a person commits an offense
if the person commits an unlawful act under Section 36.002, ranging from a
Class C misdemeanor to a first degree felony, depending on the value of
the payment or benefit provided.  Provides that if conduct constituting an
offense also constitutes an offense under another provision, an actor may
be prosecuted under either section.   

(b)  Amends Section 4.01(b), Article 4495b, V.T.C.S. (Medical Practice
Act), to make a conforming change. 

SECTION 4.11.  APPLICATION.  Makes application of this Act prospective
regarding a violation. 

ARTICLE 5.  SUSPENSION OF LICENSES

SECTION 5.01.  SUSPENSION OF LICENSES.  (a)  Amends Title 2B, Human
Resources Code, by adding Chapter 23, as follows: 

CHAPTER 23.  SUSPENSION OF LICENSE FOR FAILURE TO REIMBURSE DEPARTMENT

Sec. 23.001.  DEFINITIONS.  Defines "license" and "order suspending a
license." 


Sec. 23.002.  LICENSING AUTHORITIES SUBJECT TO CHAPTER.  Defines
"licensing authority." 

Sec. 23.003.  SUSPENSION OF LICENSE.  Sets forth the terms by which the
department is authorized to issue an order suspending a license of certain
persons. 

Sec. 23.004.  INITIATION OF PROCEEDING.  Sets forth the terms by which the
department is authorized to initiate a proceeding to suspend a person's
license.  Requires the commissioner to render a final decision in the
proceeding.   

Sec. 23.005.  CONTENTS OF PETITION.  Set forth the contents of a petition
for license suspension.   

Sec. 23.006.  NOTICE.  Requires the department to give certain notices and
a form requesting a hearing to the person named in the petition on
initiating a proceeding under Section 23.004.  

 Sec. 23.007.  HEARING ON PETITION TO SUSPEND LICENSE.  Sets forth the
procedure regarding a hearing on a petition to suspend a license.   

Sec. 23.008.  ORDER SUSPENDING LICENSE.  Sets forth the procedure by which
the department is required to render an order suspending a license, is
authorized to stay such an order, and is prohibited from rendering an
order. 

Sec. 23.009.  DEFAULT ORDER.  Requires the department to consider the
allegations of the petition for suspension to be admitted, and render an
order suspending a license if the person fails to respond to the notice,
request a hearing, or appear at the hearing.   

Sec. 23.010.  REVIEW OF FINAL ADMINISTRATIVE ORDER.  Provides that an
order issued by the department is a final agency decision and subject to
review as provided by Chapter 2001, Government Code.   

Sec. 23.011.  ACTION BY LICENSING AUTHORITY.  Requires a licensing
authority to take certain actions on receipt of a final order suspending a
license, and prohibits other actions.  Sets forth the terms by which a
person who continues to engage in the licensed activity after the
implementation of the order is liable for certain civil and criminal
penalties. Establishes that the denial or suspension of a driver's license
is governed by this chapter and not by Title 7B, Transportation Code.   

Sec. 23.012.  MOTION TO REVOKE STAY.  Sets forth the terms under which the
department is authorized to file a motion to revoke the stay of an order
suspending a license, and is required to revoke the stay and render a
final order suspending a license under certain circumstances.  

Sec. 23.013.  VACATING OR STAYING ORDER SUSPENDING A LICENSE.  Sets forth
the terms by which the department is authorized to render an order
vacating or staying an order suspending a license.  Sets forth the terms
by which on receipt of such an order, the licensing authority is required
to reinstate and return the affected license to the person. 

Sec. 23.014.  FEE BY LICENSING AUTHORITY.  Authorizes a licensing
authority to charge a fee to a person who is the subject of an order
suspending a license. 

Sec. 23.015.  COOPERATION BETWEEN LICENSING AUTHORITIES AND DEPARTMENT.
Sets forth the terms by which the department is authorized to request
certain information from each licensing authority, and by which a
licensing authority is required to provide the information.  Authorizes
the department to enter into a cooperative agreement with a licensing
authority to administer this chapter. 

Sec. 23.016.  RULES, FORMS, AND PROCEDURES.  Requires the department, by
rule, to prescribe forms and procedures for the implementation of this
chapter.   

(b)  Requires the department to take all action necessary to implement the
change in law made by this article not later than January 1, 1998.
Prohibits the department from suspending a license because of a person's
failure to reimburse the department for a benefit granted in error before
September 1, 1997. 

ARTICLE 6.  MEASUREMENT OF FRAUD

SECTION 6.01.  HEALTH CARE FRAUD STUDY.  (a)  Amends Chapter 403B,
Government Code, by adding Section 403.026, as follows: 

Sec. 403.026.  HEALTH CARE FRAUD STUDY.  Sets forth the terms by which the
comptroller is required to conduct a study each biennium to determine the
number and type of fraudulent claims for benefits submitted.  Establishes
the conditions under which the comptroller and certain state agencies are
required to cooperate and may enter into a  memorandum of understanding.
Requires the comptroller to report the results of the study in a certain
manner. 

(b)  Requires the comptroller to complete the initial study required by
Section 403.026, Government Code, not later than December 1, 1998. 

SECTION 6.02.  COMPILATION OF STATISTICS.  Amends Chapter 531B, Government
Code, by adding Section 531.0215, as follows: 

Sec. 531.0215.  COMPILATION OF STATISTICS RELATING TO FRAUD.  Requires
HHSC and each health and human services agency that administers a part of
the state Medicaid program to maintain statistics on fraudulent claims for
benefits.   

(b)  Amends Chapter 501C, Labor Code, by adding Section 501.0431, as
follows: 

Sec. 501.0431.  COMPILATION OF STATISTICS RELATING TO FRAUD.  Requires the
director to maintain statistics on fraudulent claims for medical benefits. 

(c)  Amends Section 17(a), Article 3.50-2, V.T.C.S. (Texas Employees
Uniform Group Insurance Benefits Act), to require the trustee to maintain
statistics on fraudulent claims for benefits under this Act.  

ARTICLE 7.  WAIVERS; EFFECTIVE DATE; EMERGENCY

SECTION 7.01.  WAIVERS.  Sets forth the terms by which a state agency is
required to request a waiver or authorization for implementation of a
provision.  

SECTION 7.02.  Effective date:  September 1, 1997, except as otherwise
provided by this Act. 

SECTION 7.03.  Emergency clause.