AN ACT
1-1 relating to the collection of claims for recovery of money under
1-2 subrogation and third-party reimbursement rights arising from
1-3 medical payments by health and human services agencies.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subchapter B, Chapter 531, Government Code, is
1-6 amended by adding Section 531.0391 to read as follows:
1-7 Sec. 531.0391. SUBROGATION AND THIRD-PARTY REIMBURSEMENT
1-8 COLLECTION CONTRACT. (a) The commission shall enter into a
1-9 contract under which the contractor is authorized on behalf of the
1-10 commission or a health and human services agency to recover money
1-11 under a subrogation or third-party reimbursement right held by the
1-12 commission or a health and human services agency arising from
1-13 payment of medical expenses. The contract must provide that:
1-14 (1) the commission or agency, as appropriate, shall
1-15 compensate the contractor based on a percentage of the amount of
1-16 money recovered by the contractor for the commission or agency; and
1-17 (2) with the approval of the attorney required by
1-18 other law to represent the commission or agency in court, the
1-19 contractor may represent the commission or agency in a court
1-20 proceeding to recover money under a subrogation or third-party
1-21 reimbursement right if the representation is cost-effective and
1-22 specifically authorized by the commission.
1-23 (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
3-1 senate and house of representatives with primary jurisdiction over
3-2 human services a report concerning:
3-3 (1) the commission's progress in improving collection
3-4 of money under subrogation and third-party reimbursement rights
3-5 relating to medical expenses paid by the commission and health and
3-6 human services agencies;
3-7 (2) the adequacy of existing lien and subrogation
3-8 statutes;
3-9 (3) any feature of a contract or a claims processing
3-10 procedure of the commission or a health and human services agency
3-11 that limits the ability of the commission or agency to collect
3-12 money under a subrogation or third-party reimbursement right
3-13 described by Subdivision (1) of this section; and
3-14 (4) any other matter affecting the ability of the
3-15 commission or a health and human services agency to collect money
3-16 under a subrogation or third-party reimbursement right described by
3-17 Subdivision (1) of this section.
3-18 SECTION 4. The importance of this legislation and the
3-19 crowded condition of the calendars in both houses create an
3-20 emergency and an imperative public necessity that the
3-21 constitutional rule requiring bills to be read on three several
3-22 days in each house be suspended, and this rule is hereby suspended,
3-23 and that this Act take effect and be in force from and after its
3-24 passage, and it is so enacted.
S.B. No. 534
________________________________ ________________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 534 passed the Senate on
March 5, 1997, by the following vote: Yeas 31, Nays 0;
May 28, 1997, Senate refused to concur in House amendments and
requested appointment of Conference Committee; May 29, 1997, House
granted request of the Senate; May 31, 1997, Senate adopted
Conference Committee Report by the following vote: Yeas 30,
Nays 0.
_______________________________
Secretary of the Senate
I hereby certify that S.B. No. 534 passed the House, with
amendments, on May 25, 1997, by the following vote: Yeas 139,
Nays 0, one present not voting; May 29, 1997, House granted request
of the Senate for appointment of Conference Committee;
May 31, 1997, House adopted Conference Committee Report by the
following vote: Yeas 145, Nays 0, one present not voting.
_______________________________
Chief Clerk of the House
Approved:
________________________________
Date
________________________________
Governor