By:  Nelson                                                       S.B. No. 47 
	(In the Senate - Filed November 8, 2004; January 31, 2005, 
read first time and referred to Committee on Health and Human 
Services; March 10, 2005, reported adversely, with favorable 
Committee Substitute by the following vote:  Yeas 5, Nays 1; 
March 10, 2005, sent to printer.)


COMMITTEE SUBSTITUTE FOR S.B. No. 47                                     By:  Nelson


A BILL TO BE ENTITLED

AN ACT


relating to the Medicaid fraud reduction pilot program.                     
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Section 531.1063, Government Code, is amended by 
amending Subsections (d) and (g) and adding Subsections (d-1), (h), 
and (i) to read as follows:
	(d)  In implementing the program, the commission may[:        
		[(1)]  exempt recipients who are children or who are 
elderly or disabled. [; and]
	(d-1)  If the commission requires recipients who are 
children under 15 years of age to participate in the program, the 
commission may validate the identity of those children only by:
		(1)  obtaining [(2)  obtain] a fingerprint image from a 
parent or caretaker of the [a recipient who is a] child, regardless 
of whether the parent or caretaker is a recipient; or
		(2)  using an alternate method that does not involve 
obtaining the fingerprints of the child or the child's parent or 
caretaker.
	(g)  The commission shall implement [may extend] the program 
statewide as provided by Subsection (h) [to additional counties] if 
the commission determines that statewide implementation 
[expansion] would be cost-effective.
	(h)  The commission shall adopt a plan to implement the 
program statewide in phases and shall terminate the statewide 
implementation at any stage of the process if the commission 
determines that statewide implementation would not be 
cost-effective.  The plan must include for each phase:
		(1)  a description of the policies and procedures to be 
tested concerning the handling of lost, forgotten, or stolen cards 
carrying a biometric image or situations in which a biometric match 
cannot be confirmed;
		(2)  a determination of whether the commission will 
require children or persons who are elderly or disabled to 
participate in the phase and the reason or reasons for including 
children or persons who are elderly or disabled in the phase; and
		(3)  a description of the manner and location in which 
the biometric images will be initially collected.
	(i)  In developing the plan required by Subsection (h), the 
commission shall seek comments from recipients, providers, and 
other stakeholders in the state Medicaid program.
	SECTION 2.  (a)  In this section, "Medicaid fraud reduction 
pilot program" means the pilot program required by Section 
531.1063, Government Code.
	(b)  The Health and Human Services Commission, before 
implementing a phase of the Medicaid fraud reduction pilot program 
that requires mandatory participation by Medicaid recipients or 
health care providers, shall submit a report regarding the phase to 
the governor, lieutenant governor, speaker of the house of 
representatives, and presiding officer of each standing committee 
of the senate and house of representatives having jurisdiction over 
the state Medicaid program.  The report must include a description 
of each component of the plan for that phase, as required by 
Subsection (h), Section 531.1063, Government Code.
	(c)  In addition to the report required by Subsection (c), 
Section 2.23, Chapter 198, Acts of the 78th Legislature, Regular 
Session, 2003, the Health and Human Services Commission shall 
report, not later than February 1, 2006, on the status and progress 
of the Medicaid fraud reduction pilot program to the governor, 
lieutenant governor, speaker of the house of representatives, and 
presiding officer of each standing committee of the senate and 
house of representatives having jurisdiction over the state 
Medicaid program.
	(d)  The report required by Subsection (c) of this section 
must include:     
		(1)  a continued evaluation of the benefits of the 
program;                 
		(2)  an evaluation of the strengths and weaknesses of 
the policies and procedures tested in each phase required by 
Subsection (h), Section 531.1063, Government Code;
		(3)  information concerning the cost-effectiveness of 
the program;          
		(4)  if the program has been implemented statewide, any 
significant problems encountered; and
		(5)  if the Health and Human Services Commission 
requires participation by children or persons who are elderly or 
disabled, the reason or reasons for including children or persons 
who are elderly or disabled in the program.
	SECTION 3.  If before implementing any provision of this Act 
a state agency determines that a waiver or authorization from a 
federal agency is necessary for implementation of that provision, 
the agency affected by the provision shall request the waiver or 
authorization and may delay implementing that provision until the 
waiver or authorization is granted.
	SECTION 4.  This Act takes effect immediately if it receives 
a vote of two-thirds of all the members elected to each house, as 
provided by Section 39, Article III, Texas Constitution.  If this 
Act does not receive the vote necessary for immediate effect, this 
Act takes effect September 1, 2005.



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