LEGISLATIVE BUDGET BOARD
                                   Austin, Texas
         
                                   FISCAL NOTE
                               75th Regular Session
         
                                  February 25, 1997
         
         
      TO: Honorable Hugo Berlanga, Chair            IN RE:  House Bill No. 820
          Committee on Public Health                              By: Cuellar
          House
          Austin, Texas
         
         
         
         
         FROM:  John Keel, Director    
         
In response to your request for a Fiscal Note on HB820 ( Relating 
to civil actions to recover fraudulent Medicaid claims.) this 
office has detemined the following:
         
         Biennial Net Impact to General Revenue Funds by HB820-As Introduced   FN Revision 1
         
Implementing the provisions of the bill would result in a net 
negative impact of $(735,391) to General Revenue Related Funds 
through the biennium ending August 31, 1999.
         
The bill would make no appropriation but could provide the legal 
basis for an appropriation of funds to implement the provisions 
of the bill.
         
 
Fiscal Analysis
 
This bill would amend Chapter 36 of the Texas Human Resources 
Code, the Medicaid Fraud Prevention Act, which prohibits fraudulent 
conduct with regard to the Texas Medicaid program.  A private 
party would be allowed to bring suit on behalf of the State 
of Texas for violations of Chapter 36.  The person filing the 
private lawsuit would be required to serve a copy of the petition 
on the State of Texas, and within the next 60 days the Attorney 
General may investigate the allegations and intervene and proceed 
with the action or decline to take over the action.  If the 
State decides not to proceed with the action, the private plaintiff 
would have the right to continue the action.

Under this bill, 
the State could either prosecute under Chapter 36 or pursue 
administrative remedies, in which case the private plaintiff 
could proceed with its lawsuit.  If the State proceeds with 
the action, the private party would be entitled to from ten 
percent to 25 percent of any recovery.  If the State does not 
proceed with the lawsuit, the private plaintiff could receive 
an amount that the court decides is reasonable, but not less 
than 25 percent or not more than 30 percent of the total recovery.

The 
bill would also amend Chapter 531, Government Code, by adding 
Subchapter C, which would allow the Texas Health and Human Services 
Commission to grant an award to a person who reports Medicaid 
fraud if the disclosure results in the recovery of an overcharge 
or in the termination of fraud.  The amount of the award would 
be at least ten percent of the savings to the State.  The award 
by the Commission would be paid from money appropriated to the 
Commission, and additional money would not be appropriated to 
the Commission for the purpose of paying the award.

The bill 
would take effect September 1, 1997.

 
Methodolgy
 
The bill's fiscal impact to the Office of the Attorney General 
involves the creation of a private lawsuit for conduct declared 
unlawful under Chapter 36, Human Resources Code.  The Attorney 
General would be required to investigate and evaluate the merits 
of every notice of private lawsuit filed and to prosecute those 
lawsuits in which the Attorney General decides to intervene. 
 It is estimated that there could be a substantial number of 
such actions filed because of the financial incentives in the 
bill for private citizens and that this bill would require the 
Office of the Attorney General to add one Assistant Attorney 
General IV, plus three other new employees, including an investigator, 
a legal assistant, and a legal secretary.

It is estimated 
that the bill would result in costs to The Office of the Attorney 
General of $376,762 in fiscal year 1998, and $358,629 in subsequent 
years.  The difference in these amounts reflects a one-time 
purchase of capital equipment in the first year.

The bill 
allows the Attorney General not to proceed under Chapter 36, 
in which case other agencies could pursue administrative remedies, 
possibly requiring new personnel, including investigators, attorneys 
and support staff to investigate allegations of Medicaid fraud, 
assess administrative penalties, conduct administrative hearings, 
and adjudicate appeals.

The Attorney General is allowed to 
recover court costs, attorneys' fees and investigative costs 
under the Appropriations Act, which could result in an offsetting 
amount of appropriated receipts recovered by the Attorney General. 

The probable fiscal implications of implementing the provisions 
of the bill during each of the first  five years following passage 
is estimated as follows:
 
Five Year Impact:
 
Fiscal Year Probable           Change in Number   
            Savings/(Cost)     of State                                                                   
            from General       Employees from                                                             
            Revenue Fund       FY 1997                                                                    
            0001                                                                                           
       1998        ($376,762)               4.0                                                      
       1998         (358,629)               4.0                                                      
       2000         (358,629)               4.0                                                      
       2001         (358,629)               4.0                                                      
       2002         (358,629)               4.0                                                      
 
 
         Net Impact on General Revenue Related Funds:
 
The probable fiscal implication to General Revenue related funds 
during each of the first five years is estimated as follows:
 
              Fiscal Year      Probable Net Postive/(Negative)
                               General Revenue Related Funds
                                             Funds
               1998           ($376,762)
               1999            (358,629)
               2000            (358,629)
               2001            (358,629)
               2002            (358,629)
 
Similar annual fiscal implications would continue as long as 
the provisions of the bill are in effect.
          
No fiscal implication to units of local government is anticipated.
          
   Source:            Agencies:   304   Comptroller of Public Accounts
                                         302   Office of the Attorney General
                                         529   Health and Human Services Commission
                                         
                      LBB Staff:   JK ,BB ,JC