LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 76th Regular Session
March 4, 1999
TO: Honorable Judith Zaffirini, Chair, Senate Committee on
Human Services
FROM: John Keel, Director, Legislative Budget Board
IN RE: SB11 by Zaffirini (Relating to the mental state
applicable to certain violations under the state Medicaid
program), Committee Report 1st House, Substituted
**************************************************************************
* Estimated Two-Year Net Impact to General Revenue Related Funds for *
* SB11, Committee Report 1st House, Substituted: positive impact of *
* $2,600,000 through the biennium ending August 31, 2001. *
* *
* The bill would make no appropriation but could provide the legal *
* basis for an appropriation of funds to implement the provisions of *
* the bill. *
**************************************************************************
General Revenue-Related Funds, Five-Year Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2000 $1,300,000 *
* 2001 1,300,000 *
* 2002 1,300,000 *
* 2003 1,300,000 *
* 2004 1,300,000 *
****************************************************
All Funds, Five-Year Impact:
*****************************************************
* Fiscal Year Probable Revenue Gain/(Loss) from *
* General Revenue Fund *
* 0001 *
* 2000 $1,300,000 *
* 2001 1,300,000 *
* 2002 1,300,000 *
* 2003 1,300,000 *
* 2004 1,300,000 *
*****************************************************
Fiscal Analysis
It is assumed that the provisions of the bill would increase the ability
of the Health and Human Services Commission's Office of Investigations
and Enforcement to impose appropriate fiscal sanctions when the Medicaid
provider violations are serious enough to warrant exclusion plus
imposition of damages and penalties.
Methodology
Based upon the amount of recouped overpayments in fiscal year 1998, the
Health and Human Services Commission estimates that an additional 15 to
25 percent of those recoupments would have met the lesser standard of
proof established in the bill. It is estimated that between $1.3
million and $2.2 million in penalties would have been assessed in fiscal
year 1998 based upon $8.8 million in overpayments. Imposed penalties
are comprised of fines up to $2,000 per erroneous line item and up to
doubling the amount of the overpayment. For the purposes of the fiscal
estimate, the lower amount of penalty collections is assumed.
Local Government Impact
No significant fiscal implication to units of local government is
anticipated. However, to the extent local entities which are Medicaid
providers, such as hospital districts or health clinics, submit
fraudulent claims, penalties would be imposed in the same manner as
other providers.
Source Agencies: 529 Health and Human Services Commission
LBB Staff: JK, TP, AZ