Amend CSHB 2942 (house committee printing) as follows:
(1) On page 8, lines 18 and 19, strike ", inspectors general, deputy inspectors general, assistant inspectors
general,".
(2) On page 9, strike lines 24-26.
(3) On page 9, line 27, strike "(d)" and substitute "(c)".
(4) Strike page 23, line 27 through page 41, line 13.
(5) Strike page 60, line 5 through page 61, line 8, and
renumber subsequent SECTIONS of the article accordingly.
(6) Add the following appropriately numbered ARTICLE to the
bill and renumber remaining ARTICLES of the bill accordingly:
ARTICLE ____. INSPECTOR GENERAL
SECTION ____.____. Subtitle B, Title 4, Government Code, is
amended by adding Chapter 422 to read as follows:
CHAPTER 422. OFFICE OF INSPECTOR GENERAL
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 422.001. SHORT TITLE. This chapter may be cited as the
Office of Inspector General Act.
Sec. 422.002. DEFINITIONS. In this chapter:
(1) "Agency" means a board, commission, committee,
department, office, division, or other agency of the executive
branch of state government. The term does not include an
institution of higher education as defined by Section 61.003,
Education Code.
(2) "Commission" means the Health and Human Services
Commission.
(3) "Fraud" means an intentional deception or
misrepresentation made by a person with the knowledge that the
deception could result in some unauthorized benefit to that person
or some other person. The term includes any act that constitutes
fraud under applicable federal or state law.
(4) "Furnished," in reference to items or services:
(A) means items or services provided directly by,
provided under the direct supervision of, or ordered by:
(i) a physician or other individual
licensed under state law to practice the individual's profession,
either as an employee or in the individual's own capacity;
(ii) a provider; or
(iii) another supplier of services; and
(B) does not include services ordered by one
party but billed for and provided by or under the supervision of
another.
(5) "Hold on payment" means the temporary denial of
reimbursement under a federal program for items or services
furnished by a specified provider.
(6) "Inspector general" means the inspector general
appointed under Section 422.101.
(7) "Office" means the office of inspector general
established under this chapter.
(8) "Program exclusion" means the suspension of a
provider's authorization under a federal program to request
reimbursement for items or services furnished by that provider.
(9) "Provider" means a person, firm, partnership,
corporation, agency, association, institution, or other entity
that was or is approved by the commission to provide:
(A) medical assistance under contract or
provider agreement with the commission; or
(B) third-party billing vendor services under a
contract or provider agreement with the commission.
(10) "Review" includes an audit, inspection,
investigation, evaluation, or similar activity.
(11) "State funds" or "state money" includes federal
funds or money received and appropriated by the state or for which
the state has oversight responsibility.
Sec. 422.003. APPLICATION OF SUNSET ACT. The office of
inspector general is subject to Chapter 325 (Texas Sunset Act).
Unless continued in existence as provided by that chapter, the
office is abolished and this chapter expires September 1, 2021.
Sec. 422.004. AGENCY ESTABLISHMENT OF INSPECTOR GENERAL
OFFICE. An agency may not establish an office of inspector general
without specific legislative authorization.
Sec. 422.005. REFERENCE IN OTHER LAW. (a) Notwithstanding
any other provision of law, a reference in law or rule to an
agency's office of inspector general means the office of inspector
general established under this chapter.
(b) Notwithstanding any other provision of law, a reference
in law or rule to the commission's office of investigations and
enforcement or the commission's office of inspector general means
the office of inspector general established under this chapter.
[Sections 422.006-422.050 reserved for expansion]
SUBCHAPTER B. ADMINISTRATION
Sec. 422.051. OFFICE OF INSPECTOR GENERAL. (a) The office
of inspector general is an agency of this state.
(b) The office is governed by the inspector general.
(c) The office shall have its principal office and
headquarters in Austin.
(d) The office consists of the inspector general, deputy
inspectors general, and other personnel necessary to carry out the
duties of the inspector general.
Sec. 422.052. INDEPENDENCE OF OFFICE. (a) Except as
otherwise provided by this chapter, the office and inspector
general operate independently of any other agency.
(b) The inspector general, a deputy inspector general, and
the office staff are not employees of any other agency.
Sec. 422.053. ADMINISTRATIVE ATTACHMENT. A person
designated by the inspector general to serve as the deputy
inspector general for an agency, together with office staff
assigned to the deputy inspector general, are administratively
attached to the assigned agency. The assigned agency shall provide
to office personnel administrative support services.
Sec. 422.054. SERVICE LEVEL AGREEMENT. (a) The office and
each agency to which a deputy inspector general is appointed shall
enter into a service level agreement that establishes the
performance standards and deliverables with regard to
administrative support provided to the office by the agency.
(b) The service level agreement must be reviewed at least
annually to ensure that services and deliverables are provided in
accordance with the agreement.
(c) The commission shall provide to the deputy inspector
general designated for the commission and that person's staff, for
the state fiscal biennium beginning September 1, 2009, the same
level of administrative support the commission provided to the
office established under former Section 531.102 for the state
fiscal biennium beginning September 1, 2007. This subsection
expires January 1, 2012.
[Sections 422.055-422.100 reserved for expansion]
SUBCHAPTER C. INSPECTOR GENERAL AND PERSONNEL
Sec. 422.101. APPOINTMENT. (a) From a list of three or
more names submitted to the governor by the Legislative Budget
Board, the governor, with the advice and consent of the senate,
shall appoint an inspector general to serve as director of the
office.
(b) The appointment shall be made without regard to race,
color, disability, sex, religion, age, or national origin.
(c) In preparing the list and in making the appointment, the
Legislative Budget Board and the governor, respectively, shall
consider the person's knowledge of laws, experience in the
enforcement of law, honesty, integrity, education, training,
executive ability, capability for strong leadership, and
demonstrated ability in accounting, auditing, financial analysis,
law, management analysis, public administration, investigation,
criminal justice administration, or other closely related fields.
Sec. 422.102. TERM; VACANCY. (a) The inspector general
serves a two-year term that expires on February 1 of each
odd-numbered year. The inspector general may be reappointed to one
or more subsequent terms.
(b) The governor shall fill a vacancy in the office of
inspector general for the unexpired term in the same manner as the
inspector general is appointed under Section 422.101(a).
Sec. 422.103. ELIGIBILITY. (a) A person is not eligible
for appointment as inspector general or designation as a deputy
inspector general if the person or the person's spouse:
(1) is an officer or paid consultant of a business
entity or other organization that holds a license, certificate of
authority, or other authorization from an agency for which a deputy
inspector general is appointed or that receives funds from an
agency for which a deputy inspector general is appointed;
(2) owns or controls, directly or indirectly, more
than a 10 percent interest in a business entity or other
organization receiving funds from an agency for which a deputy
inspector general is appointed; or
(3) uses or receives a substantial amount of tangible
goods or funds from an agency for which a deputy inspector general
is appointed, other than compensation or reimbursement authorized
by law.
(b) A person is not eligible to serve as inspector general
or deputy inspector general if the person or the person's spouse is
required to register as a lobbyist under Chapter 305 because of the
person's or spouse's activities for compensation related to the
operation of an agency for which a deputy inspector general is
appointed.
(c) A person who is a former or current executive or manager
of an agency may not be appointed as the inspector general or a
deputy inspector general for that agency before the fifth
anniversary of the person's last day of service with the agency.
(d) The inspector general, a deputy inspector general, or an
employee of the office may not during the person's term of
appointment or employment:
(1) become a candidate for any elective office;
(2) hold another elected or appointed public office
except for an appointment on a governmental advisory board or study
commission or as otherwise expressly authorized by law;
(3) be actively involved in the affairs of any
political party or political organization; or
(4) actively participate in any campaign for any
elective office.
Sec. 422.104. CONFLICT OF INTEREST. (a) The inspector
general may not serve as an ex officio member on the governing body
of a governmental entity.
(b) The inspector general may not have a financial interest
in the transactions of the office or an agency.
(c) The inspector general and the deputy inspector general
designated for the commission may not have a financial interest in
the transactions of a provider.
Sec. 422.105. REMOVAL. The governor, with the advice and
consent of the senate, may remove the inspector general from office
as provided by Section 9, Article XV, Texas Constitution.
Sec. 422.106. DEPUTY INSPECTORS GENERAL. (a) Subject to
available appropriations and as necessary to carry out the powers
and duties of the inspector general under this chapter and other
laws granting jurisdiction to or applicable to the inspector
general, the inspector general may designate a person to serve as
the deputy inspector general for any agency or serve as a deputy
inspector general for more than one agency.
(b) The inspector general shall designate persons to serve
as the deputy inspectors general for each of the following
agencies:
(1) the Health and Human Services Commission;
(2) the Texas Youth Commission;
(3) the Texas Department of Criminal Justice;
(4) the Texas Education Agency; and
(5) the Texas Department of Transportation.
(c) A deputy inspector general is an at-will employee and
may be discharged by the inspector general without a hearing.
(d) A deputy inspector general shall report to and perform
duties as directed by the inspector general.
(e) Each agency to which a deputy inspector general is
appointed shall provide to the agency's designated deputy inspector
general facilities and support services, including suitable office
space, furniture, computer and communications equipment,
administrative support, and salary and benefits as provided by the
General Appropriations Act.
Sec. 422.107. PEACE OFFICERS. (a) The office may employ
and commission peace officers to assist the inspector general in
carrying out the duties of the office relating to detection,
investigation, and prevention of criminal wrongdoing, malfeasance,
misfeasance, or fraud, waste, and abuse in programs at an agency or
in programs receiving state or federal funds that are implemented,
administered, or overseen by or for an agency.
(b) A commissioned peace officer or otherwise designated
law enforcement officer employed by the office is not entitled to
supplemental benefits from the law enforcement and custodial
officer supplemental retirement fund unless the officer transfers
from a position, without a break in service, that qualifies for
supplemental retirement benefits from the fund.
Sec. 422.108. IN-HOUSE GENERAL COUNSEL. The inspector
general shall employ an in-house general counsel. The general
counsel must:
(1) be an attorney licensed to practice law in this
state;
(2) be in good standing with the State Bar of Texas;
and
(3) have at least five years of continuing experience
in advising senior executive management in the public or private
sector on contracts and contract management.
Sec. 422.109. EXPERTS. Subject to the availability of
funds, the inspector general and deputy inspectors general may
contract with certified public accountants, qualified management
consultants, or other professional experts as necessary to
independently perform the functions of the office.
Sec. 422.110. EMPLOYEES; TRAINING. (a) The inspector
general may appoint, employ, promote, and remove personnel as the
inspector general considers necessary for the efficient and
effective administration of the office.
(b) The inspector general shall train office personnel to
pursue, efficiently and as necessary, fraud, waste, and abuse cases
in programs at an agency or in other state or federally funded
programs implemented, administered, or overseen by or for the
agency.
Sec. 422.111. ASSISTANCE BY AGENCY EMPLOYEES. (a) The
inspector general may require employees of an agency to provide
information, resources, or other assistance to the office as the
inspector general considers necessary to fulfill the duties and
responsibilities imposed on the office under this chapter and other
law in connection with the investigation of fraud, waste, and abuse
in the provision of services for programs at an agency or in state
or federally funded programs implemented, administered, or
overseen by or for the agency.
(b) The inspector general or the deputy inspector general
for the commission may also require employees of any health and
human services agency to provide assistance under Subsection (a).
Sec. 422.112. MERIT SYSTEM. (a) The office may establish a
merit system for its employees.
(b) The merit system may be maintained in conjunction with
other agencies that are required by federal law to operate under a
merit system.
[Sections 422.113-422.150 reserved for expansion]
SUBCHAPTER D. GENERAL POWERS AND DUTIES
Sec. 422.151. GENERAL RESPONSIBILITIES. (a) The office is
responsible for:
(1) the investigation of any matter pertaining to or
involving an agency that receives state or federal funds; and
(2) the investigation, prevention, and detection of
criminal misconduct and wrongdoing and of fraud, waste, and abuse,
as defined in applicable state and federal law, in the provision or
funding of services by or for an agency or under a program
implemented, administered, or overseen by or for the agency.
(b) The inspector general shall set clear objectives,
priorities, and performance standards for the office that
emphasize:
(1) coordinating investigative efforts to
aggressively recover money;
(2) allocating resources to cases that have the
strongest supportive evidence and the greatest potential for
recovery of money; and
(3) maximizing opportunities for referral of cases to
the office of the attorney general in accordance with this chapter
and other applicable law.
(c) The inspector general shall investigate allegations of
fraud, waste, abuse, misconduct, nonfeasance, misfeasance, and
malfeasance, and violations of this chapter or other law.
(d) The office may:
(1) conduct criminal, civil, and administrative
investigations and initiate reviews of an agency as considered
appropriate by the inspector general; and
(2) receive and investigate complaints from any source
on its own initiative.
(e) The inspector general shall perform all other duties and
exercise all other powers granted to the inspector general's office
by this chapter or another law.
Sec. 422.152. GENERAL POWERS. The office has all the powers
necessary or appropriate to carry out its responsibilities and
functions under this chapter and other law. In addition to
performing functions and duties otherwise provided by law, the
office may:
(1) audit the use and effectiveness of state or
federal funds, including contract and grant funds, administered by
a person or an agency;
(2) conduct reviews, investigations, and inspections
relating to the funds described by Subdivision (1);
(3) recommend policies promoting economical and
efficient administration of the funds described by Subdivision (1)
and the prevention and detection of fraud, waste, and abuse in
administration of those funds; and
(4) conduct internal affairs investigations in
instances of fraud, waste, and abuse and in instances of misconduct
by employees, contractors, subcontractors, and vendors.
Sec. 422.153. RULEMAKING BY INSPECTOR GENERAL. (a)
Notwithstanding Section 531.0055(e) and any other law, the
inspector general shall adopt the rules necessary to administer the
functions of the office, including rules to address the imposition
of sanctions and penalties for violations and due process
requirements for imposing sanctions and penalties.
(b) A rule, standard, or form adopted by an agency that is
necessary to accomplish the duties of the office is considered to
also be a rule, standard, or form of the office and remains in
effect as a rule, standard, or form of the office until changed by
the inspector general.
(c) The rules must include standards for the office that
emphasize:
(1) coordinating investigative efforts to
aggressively recover money;
(2) allocating resources to cases that have the
strongest supportive evidence and the greatest potential for
recovery of money; and
(3) maximizing opportunities for referral of cases to
the office of the attorney general.
Sec. 422.154. STATE AUDITOR AUDITS, INVESTIGATIONS, AND
ACCESS TO INFORMATION NOT IMPAIRED. This subchapter or other law
related to the operation of the inspector general does not:
(1) take precedence over the authority of the state
auditor to conduct audits under Chapter 321 or other law; or
(2) prohibit the state auditor from conducting an
audit, investigation, or other review or from having full and
complete access to all records and other information, including
witnesses and electronic data, that the state auditor considers
necessary for the audit, investigation, or other review.
Sec. 422.155. PUBLIC PAMPHLET. (a) The office shall
provide information of public interest in the form of a pamphlet
that describes:
(1) the functions of the office, including the
functions of the inspector general;
(2) the matters or issues that may be subject to an
investigation or review performed by the office; and
(3) the manner in which a person may report an
allegation of fraud, abuse, or criminal wrongdoing to the office.
(b) The office shall make the information described by
Subsection (a) available to state officers and employees and to the
public.
Sec. 422.156. INTERNET WEBSITE. (a) The office shall
maintain an Internet website accessible to the public.
(b) The office shall post in a conspicuous place on the
office's Internet website the public interest pamphlet prepared
under Section 422.155.
(c) The office shall ensure that the office's Internet
website allows a person to report to the office an allegation of
fraud, abuse, or criminal wrongdoing related to an agency. A report
submitted through the office's Internet website, in person, or
through another means of communication may be anonymous.
Sec. 422.157. SEAL. The seal of the office shall be a
five-pointed star in the center with the words "Office of Inspector
General, State of Texas" engraved around the margin. The seal shall
be used to authenticate official documents issued by the office.
Sec. 422.158. EXECUTIVE ORDERS. (a) The governor may issue
executive orders directing agencies to implement recommendations
issued by the office for corrective or remedial actions promoting
the economical and efficient administration of money and the
detection of fraud.
(b) The governor shall submit to the lieutenant governor,
the speaker of the house of representatives, the state auditor, and
the comptroller a report of the executive orders issued under this
chapter and the compliance by agencies with those orders.
Sec. 422.159. DEFENSE BY ATTORNEY GENERAL. The attorney
general shall defend any action brought against the inspector
general, a deputy inspector general, or an employee or officer of
the office as a result of that person's official act or omission,
whether or not the person has terminated service with the office at
the time the action is instituted.
Sec. 422.160. INTERAGENCY COORDINATION. (a) The office
and the attorney general shall enter into a memorandum of
understanding to develop and implement joint written procedures for
processing cases of suspected fraud, waste, or abuse, as those
terms are defined by state or federal law, or other violations of
state or federal law under programs at an agency for which a deputy
inspector general is appointed or in programs at any agency
receiving state or federal funds that are implemented,
administered, or overseen by the agency.
(b) The memorandum of understanding shall require:
(1) the office and the attorney general to set
priorities and guidelines for referring cases to appropriate
agencies or other entities for investigation, prosecution, or other
disposition to enhance deterrence of fraud, waste, abuse, or other
violations of state or federal law, including a violation of
Chapter 102, Occupations Code, in programs and to maximize the
imposition of penalties, the recovery of money, and the successful
prosecution of cases;
(2) the office to refer each case of suspected fraud,
waste, or abuse to the attorney general not later than the 20th
business day after the date the office determines that the
existence of fraud, waste, or abuse is reasonably indicated;
(3) the attorney general to take appropriate action in
response to each case referred to the attorney general, which
action may include direct initiation of prosecution, with the
consent of the appropriate local district or county attorney,
direct initiation of civil litigation, referral to an appropriate
United States attorney, a district attorney, or a county attorney,
or referral to a collection agency for initiation of civil
litigation or other appropriate action;
(4) the office to keep detailed records for cases
processed by the office or the attorney general, including
information on the total number of cases processed and, for each
case:
(A) the agency and division to which the case is
referred for investigation;
(B) the date on which the case is referred; and
(C) the nature of the suspected fraud, waste, or
abuse;
(5) the office to notify each appropriate division of
the office of the attorney general of each case referred by the
office of inspector general;
(6) the attorney general to ensure that information
relating to each case investigated by the attorney general is
available to each division of the attorney general's office with
responsibility for investigating suspected fraud, waste, or abuse;
(7) the attorney general to notify the office of each
case the attorney general declines to prosecute or prosecutes
unsuccessfully;
(8) representatives of the office and the attorney
general to meet not less than quarterly to share case information
and determine the appropriate agency and division to investigate
each case; and
(9) the office and the attorney general to submit
information requested by the comptroller about each resolved case
for the comptroller's use in improving fraud detection.
(c) An exchange of information under this section between
the attorney general and the office or any other agency does not
affect whether the information is subject to disclosure under
Chapter 552.
(d) With respect to Medicaid fraud, in addition to the
provisions required by Subsection (b), the memorandum of
understanding required by this section must also ensure that no
barriers to direct fraud referrals to the attorney general's
Medicaid fraud control unit or unreasonable impediments to
communication between Medicaid agency employees and the Medicaid
fraud control unit are imposed and must include procedures to
facilitate the referral of cases directly to the attorney general.
Sec. 422.161. INFORMATION AND TECHNOLOGY. The office may
obtain information or technology necessary to enable the office to
meet its responsibilities under this chapter or other law.
[Sections 422.162-422.200 reserved for expansion]
SUBCHAPTER E. REVIEWS, INVESTIGATIONS, AND AUDITS
Sec. 422.201. REVIEW, INVESTIGATION, AND AUDIT AUTHORITY.
(a) The inspector general may evaluate any activity or operation
of:
(1) an agency;
(2) a provider, in connection with an activity listed
in Section 422.002(9) or in connection with the provider's
relationship with the commission or a health and human services
agency as defined by Section 531.001; or
(3) a person in this state in relation to the
investigation, detection, or prevention of fraud, waste, abuse, or
employee misconduct in a program at an agency or in a state or
federally funded program implemented, administered, or overseen by
or for the agency.
(b) A review may include an investigation or other inquiry
into a specific act or allegation of, or a specific financial
transaction or practice that may involve, impropriety,
malfeasance, or nonfeasance in the obligation, spending, receipt,
or other use of state or federal money.
(c) The office shall conduct reviews and inspections to
protect the public and detect and prevent fraud, waste, and abuse in
the provision or funding of services or programs by or for an
agency.
(d) An agency or the governing body or governing officer of
an agency may not impair or prohibit the inspector general from
initiating or completing a review.
(e) With respect to an agency, the inspector general may
audit and review the use and effectiveness of state or federal
funds, including contract and grant funds, administered by a person
or agency receiving the funds in connection with an agency or state
or federally funded program implemented, administered, or overseen
by or for the agency.
Sec. 422.202. CLAIMS CRITERIA FOR INVESTIGATIONS. The
office by rule shall set specific claims criteria that, when met,
require the office to begin an investigation.
Sec. 422.203. INITIATION OF REVIEW. The inspector general
may initiate a review:
(1) on the inspector general's own initiative;
(2) at the request of an agency or the governing body
or governing officer of the agency; or
(3) based on a complaint from any source concerning a
matter described by Section 422.201.
Sec. 422.204. ACCESS TO INFORMATION. (a) To further a
review conducted by the office, the inspector general or a deputy
inspector general is entitled to access all books, records,
accounts, documents, reports, vouchers, databases, systems, or
other information, including confidential information, electronic
data, and internal records relevant to the functions of the office
that are maintained by or for a person, agency, or provider, if
applicable, in connection with an agency or a state or federally
funded program implemented, administered, or overseen by or for the
agency. The inspector general's authority under this subsection
supersedes any claim of privilege.
(b) The inspector general or deputy inspector general may
not access data or other information the release of which is
restricted under federal law unless the appropriate federal agency
approves the release to the office or its agent.
Sec. 422.205. COOPERATION REQUIRED. To further a review
conducted by the inspector general's office, the inspector general
or deputy inspector general may require medical or other
professional assistance from an agency or an auditor, accountant,
or other employee of the agency.
Sec. 422.206. EMPLOYEE REPORTS. The inspector general may
require employees at an agency to report to the office information
regarding fraud, waste, misuse or abuse of funds or resources,
corruption, or illegal acts.
Sec. 422.207. SUBPOENAS. (a) The inspector general may
issue a subpoena to compel the attendance of a relevant witness at a
hearing or deposition under this chapter or to compel the
production, for inspection or copying, of books, papers, records,
documents, or other relevant materials, including electronic data,
in connection with a review, hearing, or deposition conducted under
this chapter. The inspector general may issue a subpoena for the
records of any person receiving any funds from an agency under a
contract for the delivery of goods or services to this state.
(b) The inspector general may delegate the authority to
issue subpoenas to a deputy inspector general.
(c) A subpoena may be served personally or by certified
mail. If a person fails to comply with a subpoena, the inspector
general, acting through the attorney general, may file suit to
enforce the subpoena in a district court in this state.
(d) On finding that good cause exists for issuing the
subpoena, the court shall order the person to comply with the
subpoena. The court may hold in contempt a person who fails to obey
the court order.
(e) The reimbursement of the expenses of a witness whose
attendance is compelled under this section is governed by Section
2001.103.
(f) Nothing in this section limits or alters a person's
rights under state or federal law.
Sec. 422.208. INTERNAL AUDITOR. (a) In this section,
"internal auditor" means a person appointed under Section 2102.006.
(b) The internal auditor for an agency shall provide the
inspector general with a copy of the agency's internal audit plan
to:
(1) assist in the coordination of efforts between the
inspector general and the internal auditor; and
(2) limit duplication of effort regarding reviews by
the inspector general and internal auditor.
(c) The internal auditor shall provide to the inspector
general all final audit reports concerning audits of any:
(1) part or division of the agency;
(2) contract, procurement, or grant; and
(3) program conducted by the agency.
Sec. 422.209. COOPERATION WITH LAW ENFORCEMENT OFFICIALS
AND OTHER ENTITIES. (a) The inspector general may provide
information and evidence relating to criminal acts to the state
auditor's office and appropriate law enforcement officials.
(b) The inspector general may refer matters for further
civil, criminal, and administrative action to appropriate
administrative and prosecutorial agencies, including the attorney
general.
(c) The inspector general may enter into a memorandum of
understanding with a law enforcement or prosecutorial agency,
including the attorney general, to assist in conducting a review
under this chapter.
(d) The office may conduct joint investigations with the
attorney general or law enforcement agencies.
(e) The attorney general or prosecutor shall inform the
inspector general on whether an investigation is ongoing with
regard to any matter referred by the inspector general.
(f) The attorney general or a prosecutor that decides not to
investigate or prosecute a complaint alleging criminal conduct
referred to the attorney general or prosecutor by the inspector
general shall promptly notify the inspector general of that
decision.
Sec. 422.210. COOPERATION AND COORDINATION WITH STATE
AUDITOR. (a) The state auditor may, on request of the inspector
general, provide appropriate information or other assistance to the
inspector general or office, as determined by the state auditor.
(b) The inspector general may meet with the state auditor's
office to coordinate a review conducted under this chapter, share
information, or schedule work plans.
(c) The state auditor is entitled to access all information
maintained by the inspector general, including vouchers,
electronic data, internal records, and information obtained under
Section 422.204 or subject to Section 422.253.
(d) Any information obtained or provided by the state
auditor under this section is confidential and not subject to
disclosure under Chapter 552.
Sec. 422.211. PREVENTION. (a) The inspector general may
recommend to an agency or the presiding officer of the agency
policies on:
(1) promoting economical and efficient administration
of state or federal funds administered by an individual or entity
that received the funds from an agency; and
(2) preventing and detecting fraud, waste, and abuse
in the administration of those funds.
(b) The inspector general may provide training or other
education regarding the prevention of fraud, waste, and abuse to
employees of an agency. The training or education provided must be
approved by the presiding officer of the agency.
Sec. 422.212. AWARD FOR REPORTING FRAUD, WASTE, ABUSE, OR
OVERCHARGES. (a) If the office determines that the report results
in the recovery of an administrative or civil penalty imposed by
law, the office may grant an award to an individual who reports:
(1) activity that constitutes fraud, waste, or abuse
of money related to any agency programs or in programs receiving
state or federal funds that are implemented, administered, or
overseen by the agency; or
(2) overcharges in a program described by Subdivision
(1).
(b) The office may not grant an award to an individual in
connection with a report if the office or attorney general had
independent knowledge of the activity reported by the individual.
(c) The office shall determine the amount of an award
granted under this section. The amount may not exceed five percent
of the amount of the administrative or civil penalty imposed by law
that resulted from the individual's report.
(d) In determining the amount of an award granted under this
section, the office:
(1) shall consider the importance of the report in
ensuring the fiscal integrity of the program; and
(2) may consider whether the individual participated
in the reported fraud, waste, abuse, or overcharge.
(e) A person who brings an action under Subchapter C,
Chapter 36, Human Resources Code, is not eligible for an award under
this section.
Sec. 422.213. RULEMAKING BY PRESIDING OFFICER OF AGENCY.
An agency may adopt rules governing the agency's response to
reports and referrals from the inspector general on issues
identified by the inspector general related to the agency or a
contractor of the agency.
Sec. 422.214. ALLEGATIONS OF MISCONDUCT AGAINST PRESIDING
OFFICER. If a review by the inspector general involves allegations
that a presiding officer of the governing body of an agency, or if
applicable the single state officer who governs the agency, has
engaged in misconduct, the inspector general shall report to the
governor during the review until the report is completed or the
review is closed without a finding.
Sec. 422.215. RIGHT TO DECLINE INVESTIGATION. The
inspector general may decline to investigate a complaint that the
inspector general determines:
(1) is trivial, frivolous, or vexatious;
(2) was not made in good faith;
(3) is based on a situation for which too much time has
passed to justify an investigation;
(4) may not be adequately investigated with the
resources available, considering established priorities; or
(5) addresses a matter that is not within the
inspector general's investigatory authority.
[Sections 422.216-422.250 reserved for expansion]
SUBCHAPTER F. REPORTS
Sec. 422.251. REPORTING OFFICE FINDINGS. Unless the
findings would compromise an ongoing investigation by the attorney
general or law enforcement, the inspector general shall report the
findings of the office in connection with a review conducted under
this chapter to:
(1) the presiding officer of the governing body of the
agency, or if applicable the single state officer who governs the
agency;
(2) the governor;
(3) the lieutenant governor;
(4) the speaker of the house of representatives;
(5) the comptroller;
(6) the state auditor; and
(7) the attorney general.
Sec. 422.252. FLAGRANT VIOLATIONS. The inspector general
may report to the presiding officer of the governing body of the
agency associated with the review, or if applicable the single
state officer who governs the agency, the governor, and the state
auditor a particularly serious or flagrant problem relating to the
administration of a program, operation of the agency, or
interference with an inspector general review.
Sec. 422.253. INFORMATION CONFIDENTIAL. (a) Except as
provided by this chapter, all information and material compiled by
the inspector general during a review under this chapter is:
(1) confidential and not subject to disclosure under
Chapter 552; and
(2) not subject to disclosure, discovery, subpoena, or
other means of legal compulsion for release to anyone other than the
state auditor's office, the agency that is the subject of a review,
or the office or its agents involved in the review related to that
information or material.
(b) As the inspector general determines appropriate,
information relating to a review may be disclosed to:
(1) a law enforcement agency;
(2) the attorney general;
(3) the state auditor; or
(4) the agency that is the subject of a review.
(c) A person that receives information under Subsection (b)
may not disclose the information except to the extent that
disclosure is consistent with the authorized purpose for which the
person received the information.
Sec. 422.254. DRAFT OF FINAL REVIEW REPORT; AGENCY
RESPONSE. (a) Except in cases in which the office has determined
that potential fraud, waste, or abuse exists, the office shall
provide a draft of the final review report of any investigation,
audit, or review of the operations of an agency to the presiding
officer of the governing body of the agency, or if applicable to the
single state officer who governs the agency, before publishing the
office's final review report.
(b) The agency may provide a response to the office's draft
report in the manner prescribed by the office not later than the
10th day after the date the draft report is received by the agency.
The inspector general by rule shall specify the format of and
requirements for the agency response.
(c) Notwithstanding Subsection (a), the office may not
provide a draft report to the presiding officer of the governing
body of the agency, or if applicable to the single state officer who
governs the agency, if in the inspector general's opinion providing
the draft report could negatively affect any anticipated civil or
criminal proceedings.
(d) The office may include any portion of the agency's
response in the office's final report.
Sec. 422.255. FINAL REVIEW REPORTS; AGENCY RESPONSE. (a)
The inspector general shall prepare a final report for each review
conducted under this chapter. The final report must include:
(1) a summary of the activities performed by the
inspector general in conducting the review;
(2) a determination of whether wrongdoing was found;
and
(3) a description of any findings of wrongdoing.
(b) The inspector general's final review reports are
subject to disclosure under Chapter 552.
(c) All working papers and other documents related to
compiling the final review reports remain confidential and are not
subject to disclosure under Chapter 552.
(d) Not later than the 60th day after the date the office
issues a final report that identifies deficiencies or
inefficiencies in, or recommends corrective measures in the
operations of, an agency, the agency shall file a response that
includes:
(1) an implementation plan and timeline for
implementing corrective measures; or
(2) the agency's rationale for declining to implement
corrective measures for the identified deficiencies or
inefficiencies or the office's recommended corrective measures, as
applicable.
Sec. 422.256. COSTS. (a) The inspector general shall
maintain information regarding the cost of reviews.
(b) The inspector general may cooperate with appropriate
administrative and prosecutorial agencies, including the attorney
general, in recovering costs incurred under this chapter from
nongovernmental entities, including contractors or individuals
involved in:
(1) violations of applicable state or federal rules or
statutes;
(2) abusive or wilful misconduct; or
(3) violations of a provider contract or program
policy.
Sec. 422.257. SEMIANNUAL REPORT; LEGISLATIVE REPORT. (a)
The office shall prepare and submit a semiannual report to the
governor, the lieutenant governor, the speaker of the house of
representatives, the state auditor, the comptroller, and each
member of the legislature concerning:
(1) any completed final review; and
(2) the activities of the office and the attorney
general in detecting and preventing fraud, waste, and abuse under
any agency programs or in programs receiving state or federal funds
that are implemented, administered, or overseen by an agency that
is reviewed by the office under this chapter.
(b) Not later than December 1 of each even-numbered year,
the office shall issue to each member of the legislature a report
that contains the information required under Subsection (a) for the
two years immediately preceding the legislative session. The
office shall make the report available to the public.
[Sections 422.258-422.300 reserved for expansion]
SUBCHAPTER G. HEALTH AND HUMAN SERVICES POWERS AND DUTIES
Sec. 422.301. GENERAL HEALTH AND HUMAN SERVICES POWERS.
The office has all the powers necessary or appropriate to carry out
its responsibilities and functions under this chapter and other law
in relation to health and human services matters. In addition to
performing functions and duties otherwise provided by law, the
office may provide for coordination between the office and special
investigative units formed by managed care organizations under
Section 531.113 or entities with which managed care organizations
contract under that section.
Sec. 422.302. HEALTH AND HUMAN SERVICES RESPONSIBILITIES.
The office is responsible for:
(1) the investigation of fraud, waste, and abuse in
the provision or funding of health or human services by this state;
(2) the enforcement of state law relating to the
provision of those services to protect the public; and
(3) the prevention and detection of crime relating to
the provision of those services.
Sec. 422.303. INTEGRITY REVIEW FOR MEDICAID PROGRAM. (a)
The deputy inspector general designated for the commission shall
conduct an integrity review to determine whether there is
sufficient basis to warrant a full investigation on receipt of any
complaint of fraud, waste, or abuse of funds in the state Medicaid
program from any source.
(b) An integrity review under this section must begin not
later than the 30th day after the date the office receives a
complaint or has reason to believe that Medicaid fraud, waste, or
abuse has occurred. An integrity review shall be completed not
later than the 90th day after the date the review began.
(c) If the findings of an integrity review give the office
reason to believe that an incident of fraud involving possible
criminal conduct has occurred in the state Medicaid program, the
office must take the following action, as appropriate, not later
than the 30th day after the completion of the integrity review:
(1) if a provider is suspected of fraud involving
criminal conduct, the office must refer the case to the state's
Medicaid fraud control unit, provided that the criminal referral
does not preclude the office from continuing its investigation of
the provider or preclude the imposition of appropriate
administrative or civil sanctions; or
(2) if there is reason to believe that a recipient of
funds has defrauded the Medicaid program, the office may conduct a
full investigation of the suspected fraud.
Sec. 422.304. REFERRAL TO STATE MEDICAID FRAUD CONTROL
UNIT. (a) At the time the office learns or has reason to suspect
that a health or human services provider's records related to
participation in the state Medicaid program are being withheld,
concealed, destroyed, fabricated, or in any way falsified, the
office shall immediately refer the case to the state's Medicaid
fraud control unit.
(b) A criminal referral under Subsection (a) does not
preclude the office from continuing its investigation of a health
or human services provider or the imposition of appropriate
administrative or civil sanctions.
Sec. 422.305. HOLD ON CLAIM REIMBURSEMENT PAYMENT;
EXCLUSION FROM PROGRAMS. (a) In addition to other instances
authorized under state or federal law, the office shall impose
without prior notice a hold on payment of claims for reimbursement
submitted by a health or human services provider to compel
production of records related to participation in the state
Medicaid program or on request of the state's Medicaid fraud
control unit, as applicable.
(b) The office must notify the health or human services
provider of the hold on payment not later than the fifth working day
after the date the payment hold is imposed.
(c) The office shall, in consultation with the state's
Medicaid fraud control unit, establish guidelines under which holds
on payment or exclusions from a health and human services program:
(1) may permissively be imposed on a health or human
services provider; or
(2) shall automatically be imposed on a provider.
(d) A health or human services provider subject to a hold on
payment or excluded from a program under this section is entitled to
a hearing on the hold or exclusion. A hearing under this subsection
is a contested case hearing under Chapter 2001. The State Office of
Administrative Hearings shall conduct the hearing. After the
hearing, the office, subject to judicial review, shall make a final
determination. The commission, a health and human services agency,
and the attorney general are entitled to intervene as parties in the
contested case.
Sec. 422.306. REQUEST FOR EXPEDITED HEARING. (a) On timely
written request by a health or human services provider subject to a
hold on payment under Section 422.305, other than a hold requested
by the state's Medicaid fraud control unit, the office shall file a
request with the State Office of Administrative Hearings for an
expedited administrative hearing regarding the hold.
(b) The health or human services provider must request an
expedited hearing not later than the 10th day after the date the
provider receives notice from the office under Section 422.305(b).
Sec. 422.307. INFORMAL RESOLUTION. (a) The inspector
general shall adopt rules that allow a health or human services
provider subject to a hold on payment under Section 422.305, other
than a hold requested by the state's Medicaid fraud control unit, to
seek an informal resolution of the issues identified by the office
in the notice provided under that section.
(b) A health or human services provider that seeks an
informal resolution must do so not later than the 10th day after the
date the provider receives notice from the office under Section
422.305(b).
(c) A health or human services provider's decision to seek
an informal resolution does not extend the time by which the
provider must request an expedited administrative hearing under
Section 422.306.
(d) A hearing initiated under Section 422.305 shall be
stayed at the office's request until the informal resolution
process is completed.
[Sections 422.308-422.450 reserved for expansion]
SUBCHAPTER J. PENALTIES
Sec. 422.451. ADMINISTRATIVE OR CIVIL PENALTY; INJUNCTION.
(a) The office may request that the attorney general obtain an
injunction to prevent a person from disposing of an asset
identified by the office as potentially subject to recovery by the
office due to the person's fraud, waste, or abuse.
(b) The office may act for an agency in assessing
administrative or civil penalties the agency is authorized to
assess under applicable law if:
(1) the inspector general is required to designate a
deputy inspector general for the agency under Section 422.106;
(2) the agency is a health and human services agency as
defined by Section 531.001; or
(3) the penalty is imposed in connection with fraud,
waste, or abuse in the use of state or federal funds.
(c) If the office imposes an administrative or civil penalty
under Subsection (b) for an agency:
(1) the agency may not impose an administrative or
civil penalty against the same person for the same violation; and
(2) the office shall impose the penalty under
applicable rules of the office, this chapter, and applicable laws
governing the imposition of a penalty by the agency.
SECTION ____.____. Section 20.038, Business & Commerce
Code, is amended to read as follows:
Sec. 20.038. EXEMPTION FROM SECURITY FREEZE. A security
freeze does not apply to a consumer report provided to:
(1) a state or local governmental entity, including a
law enforcement agency or court or private collection agency, if
the entity, agency, or court is acting under a court order, warrant,
subpoena, or administrative subpoena;
(2) a child support agency as defined by Section
101.004, Family Code, acting to investigate or collect child
support payments or acting under Title IV-D of the Social Security
Act (42 U.S.C. Section 651 et seq.);
(3) the office of inspector general [Health and Human
Services Commission] acting to investigate fraud, waste, or abuse
in state agencies under Chapter 422, Government Code, or other law
[under Section 531.102, Government Code];
(4) the comptroller acting to investigate or collect
delinquent sales or franchise taxes;
(5) a tax assessor-collector acting to investigate or
collect delinquent ad valorem taxes;
(6) a person for the purposes of prescreening as
provided by the Fair Credit Reporting Act (15 U.S.C. Section 1681 et
seq.), as amended;
(7) a person with whom the consumer has an account or
contract or to whom the consumer has issued a negotiable
instrument, or the person's subsidiary, affiliate, agent,
assignee, prospective assignee, or private collection agency, for
purposes related to that account, contract, or instrument;
(8) a subsidiary, affiliate, agent, assignee, or
prospective assignee of a person to whom access has been granted
under Section 20.037(b);
(9) a person who administers a credit file monitoring
subscription service to which the consumer has subscribed;
(10) a person for the purpose of providing a consumer
with a copy of the consumer's report on the consumer's request;
(11) a check service or fraud prevention service
company that issues consumer reports:
(A) to prevent or investigate fraud; or
(B) for purposes of approving or processing
negotiable instruments, electronic funds transfers, or similar
methods of payment;
(12) a deposit account information service company
that issues consumer reports related to account closures caused by
fraud, substantial overdrafts, automated teller machine abuses, or
similar negative information regarding a consumer to an inquiring
financial institution for use by the financial institution only in
reviewing a consumer request for a deposit account with that
institution; or
(13) a consumer reporting agency that:
(A) acts only to resell credit information by
assembling and merging information contained in a database of
another consumer reporting agency or multiple consumer reporting
agencies; and
(B) does not maintain a permanent database of
credit information from which new consumer reports are produced.
SECTION ____.____. Article 2.12, Code of Criminal
Procedure, is amended to read as follows:
Art. 2.12. WHO ARE PEACE OFFICERS. The following are peace
officers:
(1) sheriffs, their deputies, and those reserve
deputies who hold a permanent peace officer license issued under
Chapter 1701, Occupations Code;
(2) constables, deputy constables, and those reserve
deputy constables who hold a permanent peace officer license issued
under Chapter 1701, Occupations Code;
(3) marshals or police officers of an incorporated
city, town, or village, and those reserve municipal police officers
who hold a permanent peace officer license issued under Chapter
1701, Occupations Code;
(4) rangers and officers commissioned by the Public
Safety Commission and the Director of the Department of Public
Safety;
(5) investigators of the district attorneys', criminal
district attorneys', and county attorneys' offices;
(6) law enforcement agents of the Texas Alcoholic
Beverage Commission;
(7) each member of an arson investigating unit
commissioned by a city, a county, or the state;
(8) officers commissioned under Section 37.081,
Education Code, or Subchapter E, Chapter 51, Education Code;
(9) officers commissioned by the General Services
Commission;
(10) law enforcement officers commissioned by the
Parks and Wildlife Commission;
(11) airport police officers commissioned by a city
with a population of more than 1.18 million that operates an airport
that serves commercial air carriers;
(12) airport security personnel commissioned as peace
officers by the governing body of any political subdivision of this
state, other than a city described by Subdivision (11), that
operates an airport that serves commercial air carriers;
(13) municipal park and recreational patrolmen and
security officers;
(14) security officers and investigators commissioned
as peace officers by the comptroller;
(15) officers commissioned by a water control and
improvement district under Section 49.216, Water Code;
(16) officers commissioned by a board of trustees
under Chapter 54, Transportation Code;
(17) investigators commissioned by the Texas Medical
Board;
(18) officers commissioned by the board of managers of
the Dallas County Hospital District, the Tarrant County Hospital
District, or the Bexar County Hospital District under Section
281.057, Health and Safety Code;
(19) county park rangers commissioned under
Subchapter E, Chapter 351, Local Government Code;
(20) investigators employed by the Texas Racing
Commission;
(21) officers commissioned under Chapter 554,
Occupations Code;
(22) officers commissioned by the governing body of a
metropolitan rapid transit authority under Section 451.108,
Transportation Code, or by a regional transportation authority
under Section 452.110, Transportation Code;
(23) investigators commissioned by the attorney
general under Section 402.009, Government Code;
(24) security officers and investigators commissioned
as peace officers under Chapter 466, Government Code;
(25) an officer employed by the Department of State
Health Services under Section 431.2471, Health and Safety Code;
(26) officers appointed by an appellate court under
Subchapter F, Chapter 53, Government Code;
(27) officers commissioned by the state fire marshal
under Chapter 417, Government Code;
(28) an investigator commissioned by the commissioner
of insurance under Section 701.104, Insurance Code;
(29) apprehension specialists [and inspectors
general] commissioned by the Texas Youth Commission as officers
under Section [Sections 61.0451 and] 61.0931, Human Resources Code;
(30) [officers appointed by the inspector general of
the Texas Department of Criminal Justice under Section 493.019,
Government Code;
[(31)] investigators commissioned by the Commission
on Law Enforcement Officer Standards and Education under Section
1701.160, Occupations Code;
(31) [(32)] commission investigators commissioned by
the Texas Private Security Board under Section 1702.061(f),
Occupations Code;
(32) [(33)] the fire marshal and any officers,
inspectors, or investigators commissioned by an emergency services
district under Chapter 775, Health and Safety Code;
(33) [(34)] officers commissioned by the State Board
of Dental Examiners under Section 254.013, Occupations Code,
subject to the limitations imposed by that section; [and]
(34) [(35)] investigators commissioned by the Texas
Juvenile Probation Commission as officers under Section 141.055,
Human Resources Code; and
(35) officers commissioned by the office of inspector
general established under Chapter 422, Government Code.
SECTION ____.____. The following sections of the Government
Code are repealed:
(1) Section 531.102;
(2) Section 531.1021; and
(3) Section 531.103.
SECTION ____.____. (a) The repeal by this Act of Section
531.102, Government Code, does not affect the validity of a
complaint, investigation, or other proceeding initiated under that
section before the effective date of this Act. A complaint,
investigation, or other proceeding initiated under that section is
continued in accordance with the changes in law made by this Act.
(b) The repeal by this Act of Section 531.1021, Government
Code, does not affect the validity of a subpoena issued under that
section before the effective date of this Act. A subpoena issued
under that section before the effective date of this Act is governed
by the law that existed when the subpoena was issued, and the former
law is continued in effect for that purpose.
SECTION ____.____. (a) As soon as practicable after the
effective date of this Act, the Legislative Budget Board shall
submit to the governor a list with the names of at least three
persons who may be appointed as inspector general for the office of
inspector general as required by Chapter 422, Government Code, as
added by this Act.
(b) As soon as practicable after the date the governor
receives the list under Subsection (a) of this section, the
governor shall appoint an inspector general for the office of
inspector general established under Chapter 422, Government Code,
as added by this Act, to a term expiring February 1, 2011.
(c) A person serving on the effective date of this Act as
inspector general for a state agency subject to Chapter 422,
Government Code, as added by this Act, shall serve as the deputy
inspector general designated for the agency under Chapter 422,
Government Code, as added by this Act, unless and until replaced by
the inspector general.
SECTION ____.____. A contract or proceeding primarily
related to a function transferred to the office of inspector
general established under this Act is transferred to the office.
The transfer does not affect the status of a proceeding or the
validity of a contract.
SECTION ____.____. (a) All personnel and assets currently
assigned to the inspector general of an agency subject to Chapter
422, Government Code, as added by this Act, shall be promptly
transferred to the office of inspector general established under
Chapter 422 along with any equipment, documents, and records
currently assigned to or used by the inspector general of that
agency. Inventory of personnel, equipment, documents, records, and
assets to be transferred under this section shall be accomplished
jointly by the transferring agency and the inspector general
serving under Chapter 422. All funds previously appropriated or
used, from any source, by the transferring agency in support of the
transferred functions, personnel, equipment, documents, records,
or assets shall also be contemporaneously transferred to the
office.
(b) For purposes of this section, "currently assigned"
means:
(1) all personnel and vacant full-time equivalent
positions assigned to or supporting a transferred function at any
time during the state fiscal biennium beginning September 1, 2007;
and
(2) all inventory and equipment assigned to a
transferred function or transferring personnel or that was in the
possession of transferring personnel on or at any time after
October 31, 2008.
(c) All state and federal funding, including funding for
overhead costs, support costs, and lease or colocation lease costs,
for the functions to be transferred to the office of inspector
general established under Chapter 422, Government Code, as added by
this Act, shall be reallocated to that office.
(d) For purposes of federal single state agency funding
requirements, any federal funds for an agency subject to Chapter
422, Government Code, as added by this Act, that may not be
appropriated directly to the office of inspector general shall be
transferred from the single state agency receiving the funds to the
office of inspector general established under Chapter 422 if the
funds are intended for a function performed by the office.
SECTION ____.____. On the effective date of this Act:
(1) all functions, activities, employees, rules,
forms, money, property, contracts, memorandums of understanding,
records, and obligations of a previously established office of
inspector general of an agency subject to Chapter 422, Government
Code, as added by this Act, become functions, activities,
employees, rules, forms, money, property, contracts, memorandums
of understanding, records, and obligations of the office of
inspector general established under Chapter 422, without a change
in status; and
(2) all money appropriated or budgeted for the
operations of a previously established office of inspector general
at an agency subject to Chapter 422, Government Code, as added by
this Act, including money for providing administrative support, is
considered appropriated for the use of the office of inspector
general established under Chapter 422.
SECTION ____.____. (a) Each agency subject to Chapter 422,
Government Code, as added by this Act, shall take all action
necessary to provide for the orderly transfer of the assets and
responsibilities of any previously established office of inspector
general for that agency to the office of inspector general
established under Chapter 422.
(b) A rule or form adopted by a previously established
office of inspector general of an agency subject to Chapter 422,
Government Code, as added by this Act, is a rule or form of the
office of inspector general established under Chapter 422 and
remains in effect until changed by the office of inspector general.
(c) A reference in law or administrative rule to a
previously established office of inspector general of an agency
subject to Chapter 422, Government Code, as added by this Act, means
the office of inspector general established under Chapter 422.
SECTION ____.____. 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.