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.