By Maxey                                        H.B. No. 1332

      75R5382 KKA-D                           

                                A BILL TO BE ENTITLED

 1-1                                   AN ACT

 1-2     relating to the collection of claims for recovery of money under

 1-3     subrogation and third-party reimbursement rights arising from

 1-4     medical payments by health and human services agencies.

 1-5           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-6           SECTION 1.  Subchapter B, Chapter 531, Government Code, is

 1-7     amended by adding Section 531.0391 to read as follows:

 1-8           Sec. 531.0391.  SUBROGATION AND THIRD-PARTY REIMBURSEMENT

 1-9     COLLECTION CONTRACT.  (a)  The commission shall enter into a

1-10     contract under which the contractor is authorized on behalf of the

1-11     commission or a health and human services agency to recover money

1-12     under a subrogation or third-party reimbursement right held by the

1-13     commission or a health and human services agency arising from

1-14     payment of medical expenses. The contract must provide that:

1-15                 (1)  the commission or agency, as appropriate, shall

1-16     compensate the contractor based on a percentage of the amount of

1-17     money recovered by the contractor for the commission or agency; and

1-18                 (2)  with the approval of the attorney required by

1-19     other law to represent the commission or agency in court, the

1-20     contractor may represent the commission or agency in a court

1-21     proceeding to recover money under a subrogation or third-party

1-22     reimbursement right if the representation is cost-effective and

1-23     specifically authorized by the commission.

1-24           (b)  The commission shall develop a process for identifying

 2-1     claims for the recovery of money under a subrogation or third-party

 2-2     reimbursement right described by this section and referring the

 2-3     claims to the contractor.  A health and human services agency shall

 2-4     cooperate with the contractor on a claim of the agency referred to

 2-5     the contractor for collection.

 2-6           (c)  The commission is not required to enter into a contract

 2-7     under Subsection (a) if the commission cannot identify a contractor

 2-8     who is willing to contract with the commission on reasonable terms.

 2-9     If the commission cannot identify such a contractor, the commission

2-10     shall develop and implement alternative policies to ensure the

2-11     collection of money under a subrogation or third-party

2-12     reimbursement right.

2-13           (d)  The commission may allow a state agency other than a

2-14     health and human services agency to be a party to the contract

2-15     required under Subsection (a).  In that case, the commission shall

2-16     modify the contract as necessary to reflect the services to be

2-17     provided by the contractor to the additional state agency.

2-18           SECTION 2.  Not later than February 1, 1998, the Health and

2-19     Human Services Commission shall enter into an initial contract or

2-20     implement the alternative policies as required by Section 531.0391,

2-21     Government Code, as added by this Act.

2-22           SECTION 3.  Not later than September 1, 1998, the Health and

2-23     Human Services Commission shall prepare and deliver to the

2-24     governor, lieutenant governor, speaker of the house of

2-25     representatives, and clerks of the standing committees of the

2-26     senate and house of representatives with primary jurisdiction over

2-27     human services a report concerning:

 3-1                 (1)  the commission's progress in improving collection

 3-2     of money under subrogation and third-party reimbursement rights

 3-3     relating to medical expenses paid by the commission and health and

 3-4     human services agencies;

 3-5                 (2)  the adequacy of existing lien and subrogation

 3-6     statutes;

 3-7                 (3)  any feature of a contract or a claims processing

 3-8     procedure of the commission or a health and human services agency

 3-9     that limits the ability of the commission or agency to collect

3-10     money under a subrogation or third-party reimbursement right

3-11     described by Subdivision (1) of this section; and

3-12                 (4)  any other matter affecting the ability of the

3-13     commission or a health and human services agency to collect money

3-14     under a subrogation or third-party reimbursement right described by

3-15     Subdivision (1) of this section.

3-16           SECTION 4.  The importance of this legislation and the

3-17     crowded condition of the calendars in both houses create an

3-18     emergency and an imperative public necessity that the

3-19     constitutional rule requiring bills to be read on three several

3-20     days in each house be suspended, and this rule is hereby suspended,

3-21     and that this Act take effect and be in force from and after its

3-22     passage, and it is so enacted.