By: Capelo H.B. No. 3012
A BILL TO BE ENTITLED
AN ACT
relating to the prevention and detection of fraud.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 61, Health and Safety Code, is amended by
amending Section 61.066 to read as follows:
(a) A hospital district may adopt reasonable procedures for
minimizing the opportunity for fraud, for establishing and
maintaining methods for detecting and identifying situations in
which a question of fraud may exist, and for administrative
hearings to be conducted on disqualifying persons or discontinuing
services to persons in cases where fraud appears to exist.
(b) Procedures established by a hospital district for
administrative hearings conducted under this section shall provide
for appropriate due process, including procedures for appeals.
(c) Causes for disqualification include the false
representation of a present or past fact relating to immigration
status, residency, income, or resources made by a person seeking
health care assistance.
(d) Causes for disqualification of or discontinuance of
services to persons receiving health care assistance include:
(1) presentation of a fraudulent or altered drug
prescription; and
(2) abuse of prescription drug assistance, including
resale of drugs.
(e) A hospital district may seek reimbursement for the costs
of services, provided or paid by the district, from persons who are
disqualified, or whose services are discontinued under this
section.
SECTION 2. This Act takes effect September 1, 2003.