SRC-PNG H.B. 1514 76(R) BILL ANALYSIS Senate Research Center H.B. 1514 76R4946 KLA-DBy: Maxey (Zaffirini) Human Services 4/26/1999 Engrossed DIGEST Currently, the Texas Department of Health pays premiums in advance for both its fee-for-service and managed care arrangements, incurring a cost for Medicaid clients every month whether they receive health care services or not. The comptroller of public accounts matched Bureau of Vital Statistics records for 1996 and 1997 with the November 1997 medical eligibility files of the Texas Department of Human Services (DHS) and discovered that 3,395 Texans eligible for fee-for-service Medicaid remained on DHS eligibility files for 30 or more days after their deaths. Because the state pays Medicaid fee-for-service premiums in advance, this represents a potential fiscal loss to the state. This bill would implement certain procedures to ensure that the deceased are removed from Medicaid eligibility lists. PURPOSE As proposed, H.B. 1514 implements certain procedures to ensure that the deceased are removed from Medicaid eligibility lists. RULEMAKING AUTHORITY This bill does not grant any additional rulemaking authority to a state officer, institution, or agency. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 531.0214, Government Code, by adding Subsection (e), to require the Health and Human Services Commission (commission) to ensure that the database system is used each month to match Bureau of Vital Statistics death records with a list of persons eligible for medical assistance under Chapter 32, Human Resources Code, and to ensure that each person that is deceased is promptly removed from that list. SECTION 2. Amends Section 531.106, Government Code, by adding Subsection (g), to provide that the learning or neural network technology implemented under this section, each month, must match Bureau of Vital Statistics death records with Medicaid claims filed by a provider. Requires the commission, if it determines that a provider has filed a claim for services provided to a person after the person's date of death, to refer the case for investigation to the commission's office of investigations and enforcement. SECTION 3. Requires the commission to implement the matching systems required by Sections 531.0214(e) and 531.106(g), Government Code, not later than January 1, 2000. SECTION 4. Effective date: September 1, 1999. SECTION 5. Emergency clause.