BILL ANALYSIS
Senate Research Center S.B. 47
79R488 UM-D By: Nelson
Health and Human Services
AUTHOR'S/SPONSOR'S STATEMENT OF INTENT
The Medicaid Integrity Pilot is a program to reduce fraud by Medicaid providers and recipients by requiring recipients to validate their identity at the point of service through biometric identification. This program ensures that the individual presenting at the provider's office is, in fact, the same as the individual to whom the benefit the benefit card was issued. The program can also ensure that a provider only bills Medicaid for services provide to a particular recipient at the time the individual to whom the benefit was issued. As proposed, S.B. 47 directs the Health and Human Services Commission to expand the Medicaid Integrity Pilot program statewide if the evaluation of the pilot finds that it is cost-effective.
RULEMAKING AUTHORITY
This bill does not expressly grant additional rulemaking authority to any state officer, institution, or agency.
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Section 531.1063(g), Government Code, by requiring the Health and Human Services Commission (HHSC) to implement the Medicaid fraud reduction pilot program statewide, rather than authorizing HHSC to extend the program to additional counties, if HHSC determines that statewide implementation, rather than expansion, would be cost effective.
SECTION 2. (a) Requires HHSC to report, no later than February 1, 2006, on the status and progress of the Medicaid fraud reduction pilot program required by Section 531.1063 (Medicaid Fraud Pilot Program), Government Code, to certain state officials.
(b) Requires the report to include certain information.
SECTION 3. Authorizes delay of implementation until necessary federal waivers or authorizations are obtained.
SECTION 4. Effective date: upon passage or September 1, 2005.