Capitol Research Services of Texas > Reports

Medicaid Fraud Prevention - Chapter 36, Human Resources Code - 2005 Amendment

eBook

  • Senate Bill 563 (2005)
  • Ch, 36, Human Resources Code
  • PDF Format eBook (Fully searchable)
  • Report: 114 pages
  • Exhibits: 230 pages
  • Fee: $245
  • Download the eBook directly from the Capitol Research website


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Hard Copy Report

  • Senate Bill 563 (2005)
  • Ch, 36, Human Resources Code
  • Report: 114 pages
  • Exhibits: 230 pages
  • Fee: $295
  • Shipping: $20


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Abstract

In 1995, the Texas Legislature originally enacted Chapter 36, Human Resources Code, providing for the prevention of Medicaid fraud.

Numerous amendments to the Chapter were passed in 1997 and 2005.

In 1999 and 2003 minor amendments were made to conform the chapter to bills which abolished the Board of Vocational Nurse Examiners and regulated assisted living centers.

This report reviews the changes made in the text of the chapter from 1995 to 2003 and then focuses on the legislative history of S.B. 563 which amended the Chapter in 2005.

The summary of the final version of S.B. 563 stated:

Senate Bill 563 amends provisions of the Human Resources Code, Government Code, Penal Code, and Civil Practice and Remedies Code relating to the prevention of Medicaid fraud and establishes several criminal offenses ranging from a Class C misdemeanor to a first degree felony for actions that constitute Medicaid fraud. The bill broadens the definition of "provider" to include a manufacturer or distributor of a product for which the Medicaid program provides reimbursement, defines what constitutes a culpable mental state with respect to a person acting "knowingly" in committing certain unlawful acts and amends provisions related to conduct that constitutes those acts, and includes provisions relating to prohibitions against the release and disclosure of certain information and documentary material by the office of the attorney general. Senate Bill 563 authorizes the executive commissioner of the Health and Human Services Commission (HHSC) to grant an exemption to the 10-year period of ineligibility for a provider under the Medicaid program found liable for an unlawful act if enforcing the period of ineligibility is found to be harmful to the program or a beneficiary of the program and extends the period by which the state may elect to intervene and proceed with respect to certain action filed by a private person. The bill requires HHSC to implement the Medicaid fraud reduction pilot program statewide if it is determined to be cost-effective and to adopt a plan for the implementation to be phased in. Tex. S.B. 563, 79th Leg., R.S., Enrolled Summary (2005).

Exhibits

1995
1. Act of May 26, 1995, 74th Leg., R.S., ch. 824, 1995 Tex. Gen. Laws, 4202

1997
2. Act of June 1, 1997, 75th Leg., R.S., ch. 1153, 1997 Tex. Gen. Laws, 4324

1999
3. Act of May 11, 1999, 75th Leg., R.S., ch. 233, 1999 Tex. Gen. Laws, 1064

2003
4. Act of May 30, 2003, 78th Leg., R.S., ch. 824, 2003 Tex. Gen. Laws, 4202

2005
5. Tex. S.B. 563, 79th Leg., R.S., Master Bill History Report (2005)
6. Tex. S.B. 563, As Introduced, 79th Leg., R.S. (2005)
7. Tex. S.B. 563, Senate Committee Report, 79th Leg., R.S. (2005)
8. Tex. S.B. 563, Senate Committee Report, 79th Leg., R.S. (2005)
9. CAPITOL RESEARCH SERVICES, Hearings on S.B. 563 Before the Senate Committee on Health and Human Services, 79th Leg. R.S. (March 15, 2005)
10. CAPITOL RESEARCH SERVICES, Hearings on S.B. 563 Before the House Committee on Public Health, 79th Leg. R.S. (April 27, 2005)
11. CAPITOL RESEARCH SERVICES, Debate on S.B. 563 On the Floor of the House (Second Reading), 79th Leg. R.S. (May 22, 2005)
12. CAPITOL RESEARCH SERVICES, Debate on S.B. 563 On the Floor of the House (Third Reading), 79th Leg. R.S. (May 23, 2005)
13. CAPITOL RESEARCH SERVICES, Debate on S.B. 563 On the Floor of the Senate (House Amendments), 79th Leg. R.S. (May 26, 2005)
14. S.J. of Tex., 79th Leg., R.S. 743, 3848-3860 (2005)
15. HOUSE RESEARCH ORGANIZATION, S.B. 563 Bill Analysis (May 22, 2005)
16. H.J. of Tex., 79th Leg., R.S. 4039 (2005)
17. Act of May 26, 2005, 79th Leg., R.S., ch. 806, 2005 Tex. Gen. Laws, 2778
18. Tex. S.B. 563, 79th Leg., R.S., Enrolled Summary (2005)
19. SENATE RESEARCH CENTER, Bill Analysis for S.B. 563 – Enrolled (July 18, 2005)

Current Law
20. Vernon’s Human Resources Code Annotated, Chapter 36 (Vernon 2001 & Supp. 2006)