1-1 By: Alvarado (Senate Sponsor - Carona) H.B. No. 1637
1-2 (In the Senate - Received from the House May 7, 1997;
1-3 May 8, 1997, read first time and referred to Committee on Health
1-4 and Human Services; May 17, 1997, reported favorably, as amended,
1-5 by the following vote: Yeas 10, Nays 0; May 17, 1997, sent to
1-6 printer.)
1-7 COMMITTEE AMENDMENT NO. 1 By: Carona
1-8 Amend H.B. No. 1637 as follows:
1-9 (1) In SECTION 1 of the bill, in amended Section
1-10 32.039(b)(3)(A), Human Resources Code (House Engrossment page 2,
1-11 line 49), between "to" and "a", insert "an elderly person, as
1-12 defined by Section 48.002(1), a disabled person, as defined by
1-13 Section 48.002(8)(A), or".
1-14 (2) In SECTION 1 of the bill, in amended Section
1-15 32.039(b)(3)(B), Human Resources Code (House Engrossment page 2,
1-16 lines 53 and 54), strike "younger than 18 years of age" and
1-17 substitute "described by Paragraph (A)".
1-18 (3) In SECTION 1 of the bill, in proposed Section 32.039(s),
1-19 Human Resources Code (House Engrossment page 2, line 56), between
1-20 "to" and "a", insert "an elderly person, as defined by Section
1-21 48.002(1), a disabled person, as defined by Section 48.002(8)(A),
1-22 or".
1-23 (4) In SECTION 1 of the bill, in proposed Section 32.039(s),
1-24 Human Resources Code (House Engrossment page 2, line 62),
1-25 immediately following the last sentence, insert "This subsection
1-26 does not apply to a person who operates a nursing facility."
1-27 (5) In SECTION 2 of the bill (House Engrossment page 2, line
1-28 64), strike "32.043" and substitute "32.047".
1-29 (6) In SECTION 2 of the bill, in proposed Section 32.043,
1-30 Human Resources Code (House Engrossment page 2, line 65), strike
1-31 "32.043" and substitute "32.047".
1-32 (7) In SECTION 2 of the bill, in proposed Section 32.043(2),
1-33 Human Resources Code (House Engrossment page 3, line 4), between
1-34 "to" and "a", insert "an elderly person, as defined by Section
1-35 48.002(1), a disabled person, as defined by Section 48.002(8)(A),
1-36 or".
1-37 (8) In SECTION 3 of the bill, in amended Section
1-38 36.004(a)(3)(A), Human Resources Code (House Engrossment page 3,
1-39 line 21), between "to" and "a", insert "an elderly person, as
1-40 defined by Section 48.002(1), a disabled person, as defined by
1-41 Section 48.002(8)(A), or".
1-42 (9) In SECTION 3 of the bill, in amended Section
1-43 36.004(a)(3)(B), Human Resources Code (House Engrossment page 3,
1-44 line 24), strike "younger than 18 years of age" and substitute
1-45 "described by Paragraph (A)".
1-46 (10) In SECTION 4 of the bill, in amended Section
1-47 36.009(a)(1)(A), Human Resources Code (House Engrossment page 3,
1-48 line 37), between "person" and "found", insert ", other than a
1-49 person who operates a nursing facility,".
1-50 (11) In SECTION 4 of the bill, in amended Section
1-51 36.009(a)(1)(A), Human Resources Code (House Engrossment page 3,
1-52 lines 37-39), strike "for an unlawful act that resulted in injury
1-53 to a person younger than 18 years of age".
1-54 (12) In SECTION 4 of the bill, in amended Section
1-55 36.009(a)(1)(B), Human Resources Code (House Engrossment page 3,
1-56 line 41), between "person" and "found", insert ", other than a
1-57 person who operates a nursing facility,".
1-58 (13) In SECTION 4 of the bill, in amended Section
1-59 36.009(a)(1)(B), Human Resources Code (House Engrossment page 3,
1-60 lines 42 and 43), strike "for an unlawful act that resulted in
1-61 injury to a person younger than 18 years of age".
1-62 (14) In SECTION 4 of the bill, in amended Section
1-63 36.009(a)(2)(A), Human Resources Code (House Engrossment page 3,
1-64 line 46), between "person" and "found", insert "who operates a
2-1 nursing facility".
2-2 (15) In SECTION 4 of the bill, in amended Section
2-3 36.009(a)(2)(B), Human Resources Code (House Engrossment page 3,
2-4 lines 51 and 52), strike "for an unlawful act that does not result
2-5 in injury to a person younger than 18 years of age".
2-6 (16) In SECTION 4 of the bill, in amended Section
2-7 36.009(a)(2)(B), Human Resources Code (House Engrossment page 3,
2-8 line 50), between "person" and "found", insert "who operates a
2-9 nursing facility".
2-10 (17) In SECTION 4 of the bill, in amended Section
2-11 36.009(a)(2)(B), Human Resources Code (House Engrossment page 3,
2-12 lines 51 and 52), strike "for an unlawful act that does not result
2-13 in injury to a person younger than 18 years of age".
2-14 (18) In SECTION 4 of the bill, in amended Section 36.009(b),
2-15 Human Resources Code (House Engrossment page 3, lines 54 and 55),
2-16 strike "that resulted in injury to a person younger than 18 years
2-17 of age".
2-18 (19) In SECTION 4 of the bill, in amended Section 36.009(b),
2-19 Human Resources Code (House Engrossment page 3, line 57), strike
2-20 "part of the state" and substitute "part of the".
2-21 (20) In SECTION 4 of the bill, in amended Section 36.009(b),
2-22 Human Resources Code (House Engrossment page 3, line 61),
2-23 immediately following the last sentence, insert "This subsection
2-24 does not apply to a person who operates a nursing facility."
2-25 (21) In SECTION 7 of the bill (House Engrossment page 4,
2-26 line 12), between "1997" and the period, insert ", but only if
2-27 S.B. No. 30, Acts of the 75th Legislature, Regular Session, 1997,
2-28 does not become law".
2-29 A BILL TO BE ENTITLED
2-30 AN ACT
2-31 relating to increased penalties for fraudulent or other unlawful
2-32 acts committed under the state Medicaid program that result in
2-33 injury to a child.
2-34 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
2-35 SECTION 1. Section 32.039, Human Resources Code, is amended
2-36 by amending Subsection (b) and adding Subsection (s) to read as
2-37 follows:
2-38 (b) A person who presents or causes to be presented to the
2-39 department a claim that contains a statement or representation the
2-40 person knows to be false is liable to the department for:
2-41 (1) the amount paid because of the false claim and
2-42 interest on that amount determined at the rate provided by law for
2-43 legal judgments and accruing from the date on which the payment was
2-44 made;
2-45 (2) payment of a civil penalty not to exceed twice the
2-46 amount paid because of the false claim; and
2-47 (3) payment of a civil penalty of:
2-48 (A) not less than $5,000 or more than $15,000
2-49 for each item or service for which payment was claimed if the false
2-50 statement or representation results in injury to a person younger
2-51 than 18 years of age; or
2-52 (B) not more than $2,000 for each item or
2-53 service for which payment was claimed if the false statement or
2-54 representation does not result in injury to a person younger than
2-55 18 years of age.
2-56 (s) A person found liable under Subsection (b) for a false
2-57 statement or representation that resulted in injury to a person
2-58 younger than 18 years of age may not provide or arrange to provide
2-59 health care services under the medical assistance program for a
2-60 period of 10 years. The department by rule may provide for a
2-61 period of ineligibility longer than 10 years. The period of
2-62 ineligibility begins on the date on which the determination that
2-63 the person is liable becomes final.
2-64 SECTION 2. Subchapter B, Chapter 32, Human Resources Code,
2-65 is amended by adding Section 32.043 to read as follows:
2-66 Sec. 32.043. PROHIBITION OF CERTAIN HEALTH CARE SERVICE
2-67 PROVIDERS. A person is permanently prohibited from providing or
2-68 arranging to provide health care services under the medical
2-69 assistance program if:
3-1 (1) the person is convicted of an offense arising from
3-2 a fraudulent act under the program; and
3-3 (2) the person's fraudulent act results in injury to a
3-4 person younger than 18 years of age.
3-5 SECTION 3. Section 36.004(a), Human Resources Code, is
3-6 amended to read as follows:
3-7 (a) Except as provided by Subsection (c), a person who
3-8 commits an unlawful act is liable to the state for:
3-9 (1) restitution of the value of any payment or
3-10 monetary or in-kind benefit provided under the Medicaid program,
3-11 directly or indirectly, as a result of the unlawful act;
3-12 (2) interest on the value of the payment or benefit
3-13 described by Subdivision (1) at the prejudgment interest rate in
3-14 effect on the day the payment or benefit was received or paid, for
3-15 the period from the date the benefit was received or paid to the
3-16 date that restitution is paid to the state;
3-17 (3) a civil penalty of:
3-18 (A) not less than $5,000 or more than $15,000
3-19 for each unlawful act committed by the person that results in
3-20 injury to a person younger than 18 years of age; or
3-21 (B) not less than $1,000 or more than $10,000
3-22 for each unlawful act committed by the person that does not result
3-23 in injury to a person younger than 18 years of age; and
3-24 (4) two times the value of the payment or benefit
3-25 described by Subdivision (1).
3-26 SECTION 4. Section 36.009, Human Resources Code, is amended
3-27 to read as follows:
3-28 Sec. 36.009. SUSPENSION OR REVOCATION OF AGREEMENT;
3-29 PROFESSIONAL DISCIPLINE. (a) The commissioner of human services,
3-30 the commissioner of public health, the commissioner of mental
3-31 health and mental retardation, the executive director of the
3-32 Department of Protective and Regulatory Services, or the executive
3-33 director of another state health care regulatory agency:
3-34 (1) shall suspend or revoke:
3-35 (A) a provider agreement between the department
3-36 or agency and a person found liable under Section 36.004 for an
3-37 unlawful act that resulted in injury to a person younger than 18
3-38 years of age; and
3-39 (B) a permit, license, or certification granted
3-40 by the department or agency to a person found liable under Section
3-41 36.004 for an unlawful act that resulted in injury to a person
3-42 younger than 18 years of age; and
3-43 (2) may suspend or revoke:
3-44 (A) [(1)] a provider agreement between the
3-45 department or agency and a person found liable under Section 36.004
3-46 for an unlawful act that does not result in injury to a person
3-47 younger than 18 years of age; or
3-48 (B) [(2)] a permit, license, or certification
3-49 granted by the department or agency to a person found liable under
3-50 Section 36.004 for an unlawful act that does not result in injury
3-51 to a person younger than 18 years of age.
3-52 (b) A person found liable under Section 36.004 for an
3-53 unlawful act that resulted in injury to a person younger than 18
3-54 years of age may not provide or arrange to provide health care
3-55 services under the state Medicaid program for a period of 10 years.
3-56 The board of a state agency that operates part of the state
3-57 Medicaid program may by rule provide for a period of ineligibility
3-58 longer than 10 years. The period of ineligibility begins on the
3-59 date on which the determination that the person is liable becomes
3-60 final.
3-61 (c) A person licensed by a state regulatory agency who
3-62 commits an unlawful act is subject to professional discipline under
3-63 the applicable licensing law or rules adopted under that law.
3-64 SECTION 5. If before implementing any provision of this Act,
3-65 the Health and Human Services Commission or other state agency
3-66 determines that a waiver or authorization from a federal agency is
3-67 necessary for implementation, the commission or other state agency
3-68 shall request the waiver or authorization and may delay
3-69 implementing that provision until the waiver or authorization is
4-1 granted.
4-2 SECTION 6. (a) The change in law made by this Act applies
4-3 only to a violation committed on or after the effective date of
4-4 this Act. For purposes of this section, a violation is committed
4-5 on or after the effective date of this Act only if each element of
4-6 the violation occurs on or after that date.
4-7 (b) A violation committed before the effective date of this
4-8 Act is covered by the law in effect when the violation was
4-9 committed, and the former law is continued in effect for this
4-10 purpose.
4-11 SECTION 7. This Act takes effect September 1, 1997.
4-12 SECTION 8. The importance of this legislation and the
4-13 crowded condition of the calendars in both houses create an
4-14 emergency and an imperative public necessity that the
4-15 constitutional rule requiring bills to be read on three several
4-16 days in each house be suspended, and this rule is hereby suspended.
4-17 * * * * *