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A BILL TO BE ENTITLED
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AN ACT
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relating to a prohibition of recoupment of payments on certain |
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provider claims made under the Medicaid program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 32, Human Resources Code, |
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is amended by adding Section 32.0631 to read as follows: |
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Sec. 32.0631. RECOUPMENT OF CERTAIN PAYMENTS PROHIBITED. |
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The department may not recoup any part of an improper payment that |
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was made to a provider for a claim for medical services made under |
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the medical assistance program if: |
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(1) the provider actually provided a medical service |
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reimbursable under the medical assistance program; |
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(2) the provider submitted a clean claim as required |
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under the medical assistance program; and |
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(3) the reason for the improper payment was an error |
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made by the department or an organization that has contracted with |
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the department for the administration of payments under the medical |
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assistance program. |
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SECTION 2. Section 32.0631, Human Resources Code, as added |
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by this Act, applies only to improper payments for claims made under |
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the medical assistance program under Chapter 32, Human Resources |
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Code, that are made on or after the effective date of this Act. A |
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claim made before the effective date of this Act is governed by the |
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law as it existed immediately before the effective date of this Act, |
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and that law is continued in effect for that purpose. |
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SECTION 3. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 4. 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, 2015. |