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.