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A BILL TO BE ENTITLED
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AN ACT
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relating to civil remedies and qui tam provisions under the |
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Medicaid fraud prevention act. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subsection (a), Section 36.052, Human Resources |
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Code, is amended to read as follows: |
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(a) Except as provided by Subsection (c), a person who |
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commits an unlawful act is liable to the state for: |
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(1) the amount of any payment or the value of any |
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monetary or in-kind benefit provided under the Medicaid program, |
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directly or indirectly, as a result of the unlawful act, including |
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any payment made to a third party; |
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(2) interest on the amount of the payment or the value |
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of the benefit described by Subdivision (1) at the prejudgment |
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interest rate in effect on the day the payment or benefit was |
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received or paid, for the period from the date the benefit was |
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received or paid to the date that the state recovers the amount of |
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the payment or value of the benefit; |
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(3) a civil penalty of: |
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(A) not less than $5,000 or more than $15,000 for |
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each unlawful act committed by the person that results in injury to |
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an elderly person, as defined by Section 48.002(a)(1), a disabled |
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person, as defined by Section 48.002(a)(8)(A), or a person younger |
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than 18 years of age; or |
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(B) not less than $5,000 [$1,000] or more than |
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$10,000 for each unlawful act committed by the person that does not |
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result in injury to a person described by Paragraph (A); and |
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(4) two times the amount of the payment or the value of |
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the benefit described by Subdivision (1). |
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SECTION 2. Subchapter C, Chapter 36, Human Resources Code, |
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is amended by adding Section 36.1021 to read as follows: |
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Sec. 36.1021. STANDARD OF PROOF. In an action under this |
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subchapter, the state or person bringing the action must establish |
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each element of the action, including damages, by a preponderance |
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of the evidence. |
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SECTION 3. The heading to Section 36.104, Human Resources |
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Code, is amended to read as follows: |
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Sec. 36.104. STATE DECISION; CONTINUATION [OR DISMISSAL] OF |
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ACTION [BASED ON STATE DECISION]. |
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SECTION 4. Subsection (b), Section 36.104, Human Resources |
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Code, is amended to read as follows: |
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(b) If the state declines to take over the action, the |
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person bringing the action may proceed without the state's |
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participation [the court shall dismiss the action]. On request by |
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the state, the state is entitled to be served with copies of all |
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pleadings filed in the action and be provided at the state's expense |
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with copies of all deposition transcripts. If the person bringing |
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the action proceeds without the state's participation, the court, |
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without limiting the status and right of that person, may permit the |
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state to intervene at a later date on a showing of good cause. |
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SECTION 5. Section 36.110, Human Resources Code, is amended |
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by amending Subsection (a) and adding Subsection (a-1) to read as |
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follows: |
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(a) If the state proceeds with an action under this |
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subchapter, the person bringing the action is entitled, except as |
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provided by Subsection (b), to receive at least 15 [10] percent but |
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not more than 25 percent of the proceeds of the action, depending on |
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the extent to which the person substantially contributed to the |
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prosecution of the action. |
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(a-1) If the state does not proceed with an action under |
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this subchapter, the person bringing the action is entitled, except |
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as provided by Subsection (b), to receive at least 25 percent but |
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not more than 30 percent of the proceeds of the action. The |
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entitlement of a person under this subsection is not affected by any |
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subsequent intervention in the action by the state in accordance |
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with Section 36.104(b). |
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SECTION 6. (a) This Act applies only to conduct that occurs |
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on or after the effective date of this Act. Conduct that occurs |
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before the effective date of this Act is governed by the law in |
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effect at the time the conduct occurred, and that law is continued |
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in effect for that purpose. |
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(b) For purposes of this section, conduct constituting an |
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offense under the penal law of this state occurred before the |
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effective date of this Act if any element of the offense occurred |
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before that date. |
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SECTION 7. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2007. |
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* * * * * |