SRC-AXB S.B. 1588 76(R)BILL ANALYSIS Senate Research CenterS.B. 1588 By: Zaffirini Human Services 6/29/1999 Enrolled DIGEST Texas expended $7.3 billion in 1997 on its Medicaid program. The 75th Legislature directed the comptroller of public accounts to study the size and nature of fraud and overpayments in the Medicaid program and other state health care programs. S.B. 1588 requires managed care organizations to cooperate with Heath and Human Services Commission investigations. PURPOSE As enrolled, S.B. 1588 requires managed care organizations (MCO) to submit certain information to the Health and Human Services Commission (HHSC), and requires MCOs to cooperate with HHSC investigations. 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 Chapter 533A, Government Code, by adding Section 533.012, as follows: Sec. 533.012. INFORMATION FOR FRAUD CONTROL. Requires each managed care organization (MCO) to submit certain documents to the Health and Human Services Commission (HHSC). Requires submitted information to be in an HHSC prescribed form. Requires information to be updated. Requires the HHSC office of investigations and enforcement to review submitted information for fraud in the Medicaid managed care program, as appropriate. Authorizes the comptroller to review the information. Sets forth circumstances under which certain actions regarding the dispersal of fraud control information are not required. Provides that information submitted to HHSC under Subsection (a)(1) is confidential and not subject to disclosure under Chapter 552, Government Code. SECTION 2. Amends Section 533.005, Government Code, to require a contract between an MCO and HHSC to contain a requirement that the MCO provide required information, and comply with HHSC investigations and enforcement. SECTION 3.Effective date: September 1, 1999. SECTION 4. Makes application of this Act prospective. SECTION 5. Emergency clause.