By: Vaught H.B. No. 4385

A BILL TO BE ENTITLED

AN ACT

relating to the prosecution and punishment of fraud upon certain practitioners; creating an offense and providing criminal penalties.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subchapter D, Chapter 32, Penal Code, is amended by adding new section 32.53 to read as follows:

Section 32.53. FRAUD AGAINST PRACTITIONERS. (a) In this section, "practitioner" means:

(1) an individual licensed to practice acupuncture by the Texas State Board of Acupuncture Examiners;

(2) an individual licensed by the Texas Board of Nursing as a registered nurse or recognized by that board as an advanced practice nurse;

(3) an individual licensed to practice audiology by the State Board of Examiners for Speech-Language Pathology and Audiology;

(4) an individual licensed by the Texas Commission on Alcohol and Drug Abuse;

(5) an individual licensed by the Texas Board of Chiropractic Examiners;

(6) an individual licensed to practice dentistry by the State Board of Dental Examiners;

(7) an individual licensed by the Texas State Board of Examiners of Dietitians;

(8) an individual licensed by the State Committee of Examiners in the Fitting and Dispensing of Hearing Instruments;

(9) an individual licensed by the Texas State Board of Social Worker Examiners as a licensed clinical social worker;

(10) an individual licensed by the Texas State Board of Examiners of Professional Counselors;

(11) an individual licensed by the Texas State Board of Examiners of Marriage and Family Therapists;

(12) an individual licensed as an occupational therapist by the Texas Board of Occupational Therapy Examiners;

(13) an individual licensed to practice optometry by the Texas Optometry Board;

(14) an individual licensed as a physical therapist by the Texas Board of Physical Therapy Examiners;

(15) an individual licensed to practice medicine by the Texas Medical Board;

(16) an individual licensed by the Texas State Board of Physician Assistant Examiners;

(17) an individual licensed to practice podiatry by the Texas State Board of Podiatric Medical Examiners;

(18) an individual licensed as a psychological associate by the Texas State Board of Examiners of Psychologists who practices solely under the supervision of a licensed psychologist;

(19) an individual licensed as a psychologist by the Texas State Board of Examiners of Psychologists;

(20) an individual licensed to practice speech-language pathology by the State Board of Examiners for Speech-Language Pathology and Audiology;

(21) an individual licensed as a surgical assistant by the Texas State Board of Medical Examiners; and

(22) a facility licensed as a hospital.

(b) A person who is a fiduciary or who is under a contractual duty to settle claims for another person commits an offense if, with the intent to diminish or deny payment for a service provided by a practitioner, the person:

(1) misrepresents a material fact;

(2) utilizes methodologies that misstate practitioner fees; or

(3) utilizes a database in the settlement or payment for practitioner services the person knew or should have known contains inaccuracies.

(c) When separate claims are settled or paid in violation of this section pursuant to one scheme or continuing course of conduct, the conduct may be considered as one offense and the value of the claims aggregated in determining the classification of the offense.

(d) The attorney general may offer to an attorney representing the state in the prosecution of an offense under this section the investigative, technical, and litigation assistance of the attorney general's office.

(e) The attorney general may prosecute or assist in the prosecution of an offense this section on the request of the attorney representing the state.

(f) The attorney general may institute and conduct an action or prosecution in a district court of Travis County or of a county in which any part of the offense occurs.

(g) An offense under this section is:

(1) a Class C misdemeanor if the charge is less than $50;

(2) a Class B misdemeanor if the charge is $50 or more but less than $500;

(3) a Class A misdemeanor if the charge is $500 or more but less than $1,500;

(4) a state jail felony if the charge is $1,500 or more but less than $20,000;

(5) a felony of the third degree if the charge is $20,000 or more but less than $100,000;

(6) a felony of the second degree if the charge is $100,000 or more but less than $200,000; or

(7) a felony of the first degree if:

(A) the charge is $200,000 or more; or

(B) an act committed in connection with the commission of the offense places a person at risk of death or serious bodily injury.

SECTION 2. (a) The changes in law made by this Act apply only to an offense committed on or after the effective date of this Act. An offense committed before the effective date of this Act is covered by the law in effect at the time the offense was committed, and the former law is continued in effect for that purpose. For purposes of this section, an offense was committed before the effective date of this Act if any element was committed before that date.

SECTION 3. This Act takes effect September 1, 2009.