SRC-PNG C.S.H.B. 1514 76(R)    BILL ANALYSIS


Senate Research CenterC.S.H.B. 1514
76R10769 KLA-DBy: Maxey (Zaffirini)
Human Services
4/28/1999
Committee Report (Substituted)


DIGEST 

Currently, the comptroller and the state auditor's office reports possible
overpayments of approximately $162 million for Medicaid acute services.
The comptroller's Fraud Measurement Study reports that Medicaid claims may
be processed for deceased persons after their eligibility ends. A review of
Medicaid claims for 1997 indicated that 3,395 persons remained on the
Medicaid eligibility files 30 days after they died.  This bill would
require the implementation of certain procedures to ensure accuracy of
medical assistance eligibility lists. 

PURPOSE

As proposed, C.S.H.B. 1514 requires the implementation of certain
procedures to ensure accuracy of medical assistance 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 (HHSC) to ensure
that the database system is used each month to remove deceased persons from
the list of persons eligible for medical assistance by matching the list
with bureau of vital statistics death records. 

SECTION 2. Amends Section 531.106, Government Code, by adding Subsection
(g), to require the learning or neural network technology implemented under
this section to match bureau of vital statistics death records with
Medicaid claims filed by a provider.  Requires HHSC to refer to HHSC's
office of investigations and enforcement any case in which a provider
claims to have provided services to a person determined by HHSC to be
deceased.   

SECTION 3. Requires HHSC to implement the matching systems required by
Sections 531.0214(e) and 531.106(g), Government Code, not later than
December 31, 2000. 

SECTION 4. Effective date: September 1, 1999.

SECTION 5. Emergency clause.


SUMMARY OF COMMITTEE CHANGES

SECTION 3.

Requires HHSC to implement the matching systems required by Sections
531.0214(e) and 531.106(g), Government Code, not later than December 31,
2000, rather than January 1, 2000.