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A BILL TO BE ENTITLED
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AN ACT
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relating to Medicaid fraud actions. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter A, Chapter 36, Human Resources Code, |
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is amended by adding Section 36.0025 to read as follows: |
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Sec. 36.0025. MATERIALITY REQUIREMENT FOR UNLAWFUL ACTS. |
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To be actionable under this chapter, an unlawful act under Section |
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36.002 must be material to the state's decision regarding payment |
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under the Medicaid program. |
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SECTION 2. Section 36.052, Human Resources Code, is amended |
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by amending Subsection (a) and adding Subsection (f) to read as |
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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 damages resulting from [amount of] any payment |
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or [the value of any] monetary or in-kind benefit provided under the |
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Medicaid program, directly or indirectly, as a result of the |
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unlawful act, including 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 damages [the |
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amount of the payment or value of the benefit]; |
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(3) a civil penalty of: |
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(A) not less than $5,500 or the minimum amount |
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imposed as provided by 31 U.S.C. Section 3729(a), if that amount |
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exceeds $5,500, and not more than $15,000 or the maximum amount |
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imposed as provided by 31 U.S.C. Section 3729(a), if that amount |
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exceeds $15,000, for each unlawful act committed by the person that |
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results in injury to an elderly person, as defined by Section |
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48.002(a)(1), a person with a disability, as defined by Section |
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48.002(a)(8)(A), or a person younger than 18 years of age; or |
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(B) not less than $5,500 or the minimum amount |
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imposed as provided by 31 U.S.C. Section 3729(a), if that amount |
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exceeds $5,500, and not more than $11,000 or the maximum amount |
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imposed as provided by 31 U.S.C. Section 3729(a), if that amount |
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exceeds $11,000, for each unlawful act committed by the person that |
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does not result in injury to a person described by Paragraph (A); |
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and |
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(4) two times the amount of the damages [payment or the |
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value of the benefit] described by Subdivision (1). |
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(f) Chapter 33, Civil Practice and Remedies Code, applies to |
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an action brought under this section. |
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SECTION 3. Subchapter B, Chapter 36, Human Resources Code, |
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is amended by adding Section 36.056 to read as follows: |
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Sec. 36.056. LIMITATIONS PERIOD. The attorney general may |
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not bring an action under this subchapter after the later of: |
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(1) the sixth anniversary of the date the unlawful act |
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was committed; or |
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(2) the third anniversary of the date when facts |
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material to the right of action are known or reasonably should have |
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been known by the person charged with responsibility to act in the |
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circumstances, except in no event may the action be brought later |
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than the 10th anniversary of the date the unlawful act was |
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committed. |
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SECTION 4. The changes in law made by this Act apply only to |
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an action commenced on or after the effective date of this Act. An |
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action commenced before the effective date of this Act is governed |
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by the law as it existed immediately before the effective date of |
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this Act, and that law is continued in effect for that purpose. |
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SECTION 5. This Act takes effect September 1, 2021. |