1-1 By: Harris S.B. No. 534 1-2 (In the Senate - Filed February 11, 1997; February 17, 1997, 1-3 read first time and referred to Committee on Jurisprudence; 1-4 February 25, 1997, reported favorably by the following vote: Yeas 1-5 4, Nays 0; February 25, 1997, sent to printer.) 1-6 A BILL TO BE ENTITLED 1-7 AN ACT 1-8 relating to the collection of claims for recovery of money under 1-9 subrogation and third-party reimbursement rights arising from 1-10 medical payments by health and human services agencies. 1-11 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-12 SECTION 1. Subchapter B, Chapter 531, Government Code, is 1-13 amended by adding Section 531.0391 to read as follows: 1-14 Sec. 531.0391. SUBROGATION AND THIRD-PARTY REIMBURSEMENT 1-15 COLLECTION CONTRACT. (a) The commission shall enter into a 1-16 contract under which the contractor is authorized on behalf of the 1-17 commission or a health and human services agency to recover money 1-18 under a subrogation or third-party reimbursement right held by the 1-19 commission or a health and human services agency arising from 1-20 payment of medical expenses. The contract must provide that: 1-21 (1) the commission or agency, as appropriate, shall 1-22 compensate the contractor based on a percentage of the amount of 1-23 money recovered by the contractor for the commission or agency; and 1-24 (2) with the approval of the attorney required by 1-25 other law to represent the commission or agency in court, the 1-26 contractor may represent the commission or agency in a court 1-27 proceeding to recover money under a subrogation or third-party 1-28 reimbursement right if the representation is cost-effective and 1-29 specifically authorized by the commission. 1-30 (b) The commission shall develop a process for identifying 1-31 claims for the recovery of money under a subrogation or third-party 1-32 reimbursement right described by this section and referring the 1-33 claims to the contractor. A health and human services agency shall 1-34 cooperate with the contractor on a claim of the agency referred to 1-35 the contractor for collection. 1-36 (c) The commission is not required to enter into a contract 1-37 under Subsection (a) if the commission cannot identify a contractor 1-38 who is willing to contract with the commission on reasonable terms. 1-39 If the commission cannot identify such a contractor, the commission 1-40 shall develop and implement alternative policies to ensure the 1-41 collection of money under a subrogation or third-party 1-42 reimbursement right. 1-43 (d) The commission may allow a state agency other than a 1-44 health and human services agency to be a party to the contract 1-45 required under Subsection (a). In that case, the commission shall 1-46 modify the contract as necessary to reflect the services to be 1-47 provided by the contractor to the additional state agency. 1-48 SECTION 2. Not later than February 1, 1998, the Health and 1-49 Human Services Commission shall enter into an initial contract or 1-50 implement the alternative policies as required by Section 531.0391, 1-51 Government Code, as added by this Act. 1-52 SECTION 3. Not later than September 1, 1998, the Health and 1-53 Human Services Commission shall prepare and deliver to the 1-54 governor, lieutenant governor, speaker of the house of 1-55 representatives, and clerks of the standing committees of the 1-56 senate and house of representatives with primary jurisdiction over 1-57 human services a report concerning: 1-58 (1) the commission's progress in improving collection 1-59 of money under subrogation and third-party reimbursement rights 1-60 relating to medical expenses paid by the commission and health and 1-61 human services agencies; 1-62 (2) the adequacy of existing lien and subrogation 1-63 statutes; 1-64 (3) any feature of a contract or a claims processing 2-1 procedure of the commission or a health and human services agency 2-2 that limits the ability of the commission or agency to collect 2-3 money under a subrogation or third-party reimbursement right 2-4 described by Subdivision (1) of this section; and 2-5 (4) any other matter affecting the ability of the 2-6 commission or a health and human services agency to collect money 2-7 under a subrogation or third-party reimbursement right described by 2-8 Subdivision (1) of this section. 2-9 SECTION 4. The importance of this legislation and the 2-10 crowded condition of the calendars in both houses create an 2-11 emergency and an imperative public necessity that the 2-12 constitutional rule requiring bills to be read on three several 2-13 days in each house be suspended, and this rule is hereby suspended, 2-14 and that this Act take effect and be in force from and after its 2-15 passage, and it is so enacted. 2-16 * * * * *