By: Janek  S.B. No. 362
         (In the Senate - Filed January 30, 2007; February 21, 2007,
  read first time and referred to Committee on Health and Human
  Services; March 19, 2007, reported favorably by the following
  vote:  Yeas 6, Nays 0; March 19, 2007, sent to printer.)
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to civil remedies and qui tam provisions under the
  Medicaid fraud prevention act.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subsection (a), Section 36.052, Human Resources
  Code, is amended to read as follows:
         (a)  Except as provided by Subsection (c), a person who
  commits an unlawful act is liable to the state for:
               (1)  the amount of any payment or the value of any
  monetary or in-kind benefit provided under the Medicaid program,
  directly or indirectly, as a result of the unlawful act, including
  any payment made to a third party;
               (2)  interest on the amount of the payment or the value
  of the benefit described by Subdivision (1) at the prejudgment
  interest rate in effect on the day the payment or benefit was
  received or paid, for the period from the date the benefit was
  received or paid to the date that the state recovers the amount of
  the payment or value of the benefit;
               (3)  a civil penalty of:
                     (A)  not less than $5,000 or more than $15,000 for
  each unlawful act committed by the person that results in injury to
  an elderly person, as defined by Section 48.002(a)(1), a disabled
  person, as defined by Section 48.002(a)(8)(A), or a person younger
  than 18 years of age; or
                     (B)  not less than $5,000 [$1,000] or more than
  $10,000 for each unlawful act committed by the person that does not
  result in injury to a person described by Paragraph (A); and
               (4)  two times the amount of the payment or the value of
  the benefit described by Subdivision (1).
         SECTION 2.  Subchapter C, Chapter 36, Human Resources Code,
  is amended by adding Section 36.1021 to read as follows:
         Sec. 36.1021.  STANDARD OF PROOF. In an action under this
  subchapter, the state or person bringing the action must establish
  each element of the action, including damages, by a preponderance
  of the evidence.
         SECTION 3.  The heading to Section 36.104, Human Resources
  Code, is amended to read as follows:
         Sec. 36.104.  STATE DECISION; CONTINUATION [OR DISMISSAL] OF
  ACTION [BASED ON STATE DECISION].
         SECTION 4.  Subsection (b), Section 36.104, Human Resources
  Code, is amended to read as follows:
         (b)  If the state declines to take over the action, the
  person bringing the action may proceed without the state's
  participation [the court shall dismiss the action].  On request by
  the state, the state is entitled to be served with copies of all
  pleadings filed in the action and be provided at the state's expense
  with copies of all deposition transcripts.  If the person bringing
  the action proceeds without the state's participation, the court,
  without limiting the status and right of that person, may permit the
  state to intervene at a later date on a showing of good cause.
         SECTION 5.  Section 36.110, Human Resources Code, is amended
  by amending Subsection (a) and adding Subsection (a-1) to read as
  follows:
         (a)  If the state proceeds with an action under this
  subchapter, the person bringing the action is entitled, except as
  provided by Subsection (b), to receive at least 15 [10] percent but
  not more than 25 percent of the proceeds of the action, depending on
  the extent to which the person substantially contributed to the
  prosecution of the action.
         (a-1)  If the state does not proceed with an action under
  this subchapter, the person bringing the action is entitled, except
  as provided by Subsection (b), to receive at least 25 percent but
  not more than 30 percent of the proceeds of the action.  The
  entitlement of a person under this subsection is not affected by any
  subsequent intervention in the action by the state in accordance
  with Section 36.104(b).
         SECTION 6.  (a) This Act applies only to conduct that occurs
  on or after the effective date of this Act. Conduct that occurs
  before the effective date of this Act is governed by the law in
  effect at the time the conduct occurred, and that law is continued
  in effect for that purpose.
         (b)  For purposes of this section, conduct constituting an
  offense under the penal law of this state occurred before the
  effective date of this Act if any element of the offense occurred
  before that date.
         SECTION 7.  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, 2007.
 
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