LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 76th Regular Session
  
                              March 29, 1999
  
  
          TO:  Honorable Judith Zaffirini, Chair, Senate Committee on
               Human Services
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  SB1589  by Zaffirini (Relating to fraudulent claims for
               medical or health care benefits submitted under certain
               state programs.), As Introduced
  
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*  The bill would make no appropriation but could provide the legal      *
*  basis for an appropriation of funds to implement the provisions of    *
*  the bill.                                                             *
*                                                                        *
*  It is assumed that affected agencies can implement the requirements   *
*  of the bill within existing resources.                                *
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The bill would expand the scope of the health care claims study and
require that certain steps be taken to improve the accuracy of future
studies.  The bill would increase the State's ability to assess the
efficacy of its current and future fraud and abuse control efforts.

The bill would require affected agencies, such as the Employees
Retirement System (ERS) and Department of Health, to: 1) provide
information that permits examination of both patient and health care
provider histories to identify unusual or suspicious claims or patterns
of claims; 2) maintain and regularly update the names and telephone
numbers of Medicaid recipients and participants in the ERS system; and 3)
establish performance measures to be used to evaluate fraud control
procedures.

Affected agencies would be required to establish/adapt systems to capture
required data elements.  It is assumed that affected agencies can absorb
these responsibilities within existing resources.  The Comptroller of
Public Accounts reports that the bill could be expected to produce
savings for the state and federal government by reducing fraud but
cannot estimate the amount of savings.
  
Local Government Impact
  
No significant fiscal implication to units of local government is
anticipated.
  
  
Source Agencies:   
LBB Staff:         JK, TP, AZ