By Maxey H.B. No. 689 75R3409 KKA-D A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to measurement of fraud in certain state-funded health 1-3 care programs. 1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-5 SECTION 1. Subchapter B, Chapter 403, Government Code, is 1-6 amended by adding Section 403.026 to read as follows: 1-7 Sec. 403.026. HEALTH CARE FRAUD STUDY. (a) The comptroller 1-8 shall conduct a study each biennium to determine the number and 1-9 type of fraudulent claims for medical or health care benefits 1-10 submitted: 1-11 (1) under the state Medicaid program; 1-12 (2) under group health insurance programs administered 1-13 through the Employees Retirement System of Texas for active and 1-14 retired state employees; or 1-15 (3) by or on behalf of a state employee and 1-16 administered by the attorney general under Chapter 501, Labor Code. 1-17 (b) A state agency that administers a program identified by 1-18 Subsection (a) shall cooperate with the comptroller and provide any 1-19 information required by the comptroller in connection with the 1-20 study. A state agency may enter into a memorandum of understanding 1-21 with the comptroller regarding the use and confidentiality of the 1-22 information provided. This subsection does not require a state 1-23 agency to provide confidential information if release of the 1-24 information is prohibited by law. 2-1 (c) The comptroller shall report the results of the study to 2-2 each state agency that administers a program included in the study 2-3 so that the agency may modify its fraud control procedures as 2-4 necessary. 2-5 SECTION 2. Subchapter B, Chapter 531, Government Code, is 2-6 amended by adding Section 531.0215 to read as follows: 2-7 Sec. 531.0215. COMPILATION OF STATISTICS RELATING TO FRAUD. 2-8 The commission and each health and human services agency that 2-9 administers a part of the state Medicaid program shall maintain 2-10 statistics on the number, type, and disposition of fraudulent 2-11 claims for benefits submitted under the part of the program the 2-12 agency administers. 2-13 SECTION 3. Subchapter C, Chapter 501, Labor Code, is amended 2-14 by adding Section 501.0431 to read as follows: 2-15 Sec. 501.0431. COMPILATION OF STATISTICS RELATING TO FRAUD. 2-16 The director shall maintain statistics on the number, type, and 2-17 disposition of fraudulent claims for medical benefits under this 2-18 chapter. 2-19 SECTION 4. Section 17(a), Texas Employees Uniform Group 2-20 Insurance Benefits Act (Article 3.50-2, Vernon's Texas Insurance 2-21 Code), is amended to read as follows: 2-22 (a) The trustee shall: 2-23 (1) make a continuing study of the operation and 2-24 administration of this Act, including surveys and reports of group 2-25 coverages and benefits available to employees and on the experience 2-26 thereof; and 2-27 (2) maintain statistics on the number, type, and 3-1 disposition of fraudulent claims for benefits under this Act. 3-2 SECTION 5. The comptroller of public accounts shall complete 3-3 the initial study required by Section 403.026, Government Code, as 3-4 added by this Act, not later than December 1, 1998. 3-5 SECTION 6. The importance of this legislation and the 3-6 crowded condition of the calendars in both houses create an 3-7 emergency and an imperative public necessity that the 3-8 constitutional rule requiring bills to be read on three several 3-9 days in each house be suspended, and this rule is hereby suspended, 3-10 and that this Act take effect and be in force from and after its 3-11 passage, and it is so enacted.