Bill Text: TX HB2448 | 2011-2012 | 82nd Legislature | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to the creation of offices of inspectors general at the Health and Human Services Commission, Texas Youth Commission, Texas Department of Criminal Justice, Texas Department of Transportation, and Texas Education Agency; providing penalties.
Spectrum: Slight Partisan Bill (Republican 3-1)
Status: (Introduced - Dead) 2011-05-04 - Committee report sent to Calendars [HB2448 Detail]
Download: Texas-2011-HB2448-Introduced.html
Bill Title: Relating to the creation of offices of inspectors general at the Health and Human Services Commission, Texas Youth Commission, Texas Department of Criminal Justice, Texas Department of Transportation, and Texas Education Agency; providing penalties.
Spectrum: Slight Partisan Bill (Republican 3-1)
Status: (Introduced - Dead) 2011-05-04 - Committee report sent to Calendars [HB2448 Detail]
Download: Texas-2011-HB2448-Introduced.html
82R9473 EAH-D | ||
By: Harper-Brown | H.B. No. 2448 |
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relating to the creation of the office of inspector general and the | ||
appointment of deputy inspectors general at the Health and Human | ||
Services Commission, Texas Youth Commission, Texas Department of | ||
Criminal Justice, Texas Education Agency, and Texas Department of | ||
Transportation; providing penalties. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. 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 | ||
Texas Inspector General Act. | ||
Sec. 422.002. DEFINITIONS. In this chapter: | ||
(1) "Agency" means a state agency subject to this | ||
chapter under Section 422.004. | ||
(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, 2023. | ||
Sec. 422.004. APPLICABILITY. (a) Except as provided by | ||
Subsection (c), this chapter applies only to the: | ||
(1) Health and Human Services Commission; | ||
(2) Texas Youth Commission; | ||
(3) Texas Department of Criminal Justice; | ||
(4) Texas Education Agency; and | ||
(5) Texas Department of Transportation. | ||
(b) A state agency may not establish an office of inspector | ||
general without specific legislative authorization. | ||
(c) A health and human services agency as defined by Section | ||
531.001 is an agency to which this chapter applies for purposes | ||
related to the review and investigatory authority of the office. | ||
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, for an agency to which | ||
this chapter applies, 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. | ||
Sec. 422.006. INTERFERENCE PROHIBITED. The governor, the | ||
legislature or a committee of the legislature, or a state agency may | ||
not prevent the inspector general or a deputy inspector general | ||
from initiating, performing, or completing an investigation, | ||
audit, or review or any other compliance or enforcement activity | ||
pursued by the office under this chapter or other law. | ||
[Sections 422.007-422.050 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. | ||
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 state agency to which this chapter applies 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, 2011, 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, 2009. This subsection | ||
expires January 1, 2014. | ||
[Sections 422.055-422.100 reserved for expansion] | ||
SUBCHAPTER C. INSPECTOR GENERAL AND PERSONNEL | ||
Sec. 422.101. APPOINTMENT. (a) 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 making the appointment, the governor shall consider | ||
the person's knowledge of laws, experience in the enforcement of | ||
law, honesty, integrity, education, training, and executive | ||
ability. | ||
Sec. 422.102. TERM; VACANCY. (a) The inspector general | ||
serves a two-year term that expires on February 1 of each | ||
odd-numbered year. | ||
(b) The governor shall fill a vacancy in the office of | ||
inspector general for the unexpired term. | ||
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 to which this | ||
chapter applies or that receives funds from an agency to which this | ||
chapter applies; | ||
(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 to which this chapter | ||
applies; or | ||
(3) uses or receives a substantial amount of tangible | ||
goods or funds from an agency to which this chapter applies, 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 to which this chapter applies. | ||
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 to which this chapter | ||
applies. | ||
(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) The | ||
inspector general, in consultation with the office of the governor | ||
and as necessary to implement this chapter, shall designate persons | ||
to serve as deputy inspectors general for each agency to which this | ||
chapter applies. | ||
(b) A deputy inspector general shall report to and perform | ||
duties as directed by the inspector general. | ||
(c) Each agency to which this chapter applies 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 fraud, waste, and abuse in | ||
programs at an agency to which this chapter applies or in programs | ||
receiving state or federal funds that are implemented, | ||
administered, or overseen by or for the 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. 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. 422.109. EMPLOYEES; TRAINING. (a) The inspector | ||
general may employ personnel as necessary to implement the duties | ||
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 to which this chapter applies or other | ||
state or federally funded programs implemented, administered, or | ||
overseen by or for the agency. | ||
Sec. 422.110. ASSISTANCE BY AGENCY EMPLOYEES. (a) The | ||
inspector general may require employees of an agency to which this | ||
chapter applies to provide assistance to the office in connection | ||
with the office's duties relating to the investigation of fraud, | ||
waste, and abuse in the provision of services for programs at an | ||
agency to which this chapter applies or 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. 422.111. MERIT SYSTEM. (a) The office may establish a | ||
merit system for its employees. | ||
(b) The merit system may be maintained in conjunction with | ||
other state agencies that are required by federal law to operate | ||
under a merit system. | ||
[Sections 422.112-422.150 reserved for expansion] | ||
SUBCHAPTER D. GENERAL POWERS AND DUTIES | ||
Sec. 422.151. GENERAL RESPONSIBILITIES. (a) The office is | ||
responsible for the investigation 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 to which this chapter | ||
applies or under a program implemented, administered, or overseen | ||
by or for the agency. | ||
(b) The office 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. | ||
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) 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; | ||
(2) audit the use and effectiveness of state or | ||
federal funds, including contract and grant funds, administered by | ||
a person or an agency to which this chapter applies; | ||
(3) conduct reviews, investigations, and inspections | ||
relating to the funds described by Subdivision (2); | ||
(4) recommend policies promoting economical and | ||
efficient administration of the funds described by Subdivision (2) | ||
and the prevention and detection of fraud, waste, and abuse in | ||
administration of those funds; and | ||
(5) 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. 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. 422.154. 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 to which | ||
this chapter applies 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. 422.155. 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. 422.156. EXECUTIVE ORDERS. (a) The governor may issue | ||
executive orders directing state 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 may 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 state agencies with those orders. | ||
Sec. 422.157. 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. 422.158. 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 to which this | ||
chapter applies or in programs 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 state | ||
agencies 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 the 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 state 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. 422.159. 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. | ||
Sec. 422.160. PUBLIC INTEREST INFORMATION AND COMPLAINTS. | ||
(a) The office shall develop and implement policies that provide | ||
the public a reasonable opportunity to appear before the office and | ||
to speak on any issue under the office's jurisdiction. | ||
(b) The office shall prepare information of public interest | ||
describing the functions of the office and the office's procedures | ||
by which complaints are filed with and resolved by the office. The | ||
office shall make the information available to the public and | ||
appropriate state agencies. | ||
(c) The office shall keep an information file about each | ||
complaint filed with the office relating to a state agency or entity | ||
receiving state or federal money and falling under the | ||
investigatory jurisdiction of the office. | ||
[Sections 422.161-422.200 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 | ||
an agency to which this chapter applies, a provider, if applicable, | ||
or a person in this state that is related to the investigation, | ||
detection, or prevention of fraud, waste, abuse, or employee | ||
misconduct in a program at an agency to which this chapter applies | ||
or in a state or federally funded program implemented, | ||
administered, or overseen by or for the agency. 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. | ||
(b) 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 described by | ||
Subsection (a). | ||
(c) A state agency or the governing body or governing | ||
officer of a state agency may not impair or prohibit the inspector | ||
general from initiating or completing a review. | ||
(d) With respect to an agency to which this chapter applies, | ||
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 to which this chapter | ||
applies 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. 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. 422.205. 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, state agency, or provider, | ||
if applicable, in connection with an agency to which this chapter | ||
applies or a state or federally funded program implemented, | ||
administered, or overseen by or for the agency. | ||
(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. 422.206. COOPERATION REQUIRED. To further a review | ||
conducted by the office, the inspector general or deputy inspector | ||
general may require medical or other professional assistance from | ||
an agency to which this chapter applies or an auditor, accountant, | ||
or other employee of the agency. | ||
Sec. 422.207. 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. 422.208. 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. 422.209. REQUEST FOR EXPEDITED HEARING. (a) On timely | ||
written request by a health or human services provider subject to a | ||
hold on payment under Section 422.208, 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 422.208(b). | ||
Sec. 422.210. 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 422.208, 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 | ||
422.208(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 422.209. | ||
(d) A hearing initiated under Section 422.208 shall be | ||
stayed at the office's request until the informal resolution | ||
process is completed. | ||
Sec. 422.211. EMPLOYEE REPORTS. The inspector general may | ||
require employees at an agency to which this chapter applies to | ||
report to the office information regarding fraud, waste, misuse or | ||
abuse of funds or resources, corruption, or illegal acts. | ||
Sec. 422.212. SUBPOENAS. (a) The inspector general may | ||
issue a subpoena to compel the attendance of a relevant witness at a | ||
hearing or deposition under this subchapter or to compel the | ||
production, for inspection or copying, of relevant materials in | ||
connection with a review, hearing, or deposition conducted under | ||
this subchapter. | ||
(b) A subpoena may be served personally or by certified | ||
mail. | ||
(c) 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. | ||
Sec. 422.213. INTERNAL AUDITOR. (a) In this section, | ||
"internal auditor" means a person appointed under Section 2102.006. | ||
(b) The internal auditor for an agency to which this chapter | ||
applies 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. 422.214. 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 subchapter. | ||
Sec. 422.215. 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 subchapter, | ||
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 422.205 or subject to Section 422.254. | ||
(d) Any information obtained or provided by the state | ||
auditor under this section is confidential and not subject to | ||
disclosure under Chapter 552. | ||
Sec. 422.216. PREVENTION. (a) The inspector general may | ||
recommend to an agency to which this chapter applies 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 a state 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 a state agency. The training or education provided | ||
must be approved by the presiding officer of the agency. | ||
Sec. 422.217. 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. 422.218. RULEMAKING BY PRESIDING OFFICER OF AGENCY. | ||
The presiding officer of 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. 422.219. ALLEGATIONS OF MISCONDUCT AGAINST PRESIDING | ||
OFFICER. If a review by the inspector general involves allegations | ||
that a presiding officer of an 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. | ||
[Sections 422.220-422.250 reserved for expansion] | ||
SUBCHAPTER F. REPORTS | ||
Sec. 422.251. PERIODIC REPORTING REQUIRED. The inspector | ||
general shall timely inform the governor, the attorney general, the | ||
state auditor, and the presiding officer of the relevant agency of | ||
the initiation of a review of an agency program and the ongoing | ||
status of the review. | ||
Sec. 422.252. REPORTING OFFICE FINDINGS. The inspector | ||
general shall report the findings of the office in connection with a | ||
review conducted under Subchapter E to: | ||
(1) the presiding officer of 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. 422.253. FLAGRANT VIOLATIONS; IMMEDIATE REPORT. The | ||
inspector general shall immediately report to the presiding officer | ||
of the agency associated with the review, the governor's general | ||
counsel, 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. 422.254. 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. 422.255. 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 agency before publishing the office's final review | ||
report. | ||
(b) The agency director 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 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. 422.256. 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. 422.257. 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. 422.258. SEMIANNUAL REPORT. The office and the | ||
attorney general shall jointly 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 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 a state agency that is reviewed by the office under this | ||
chapter. The report may be consolidated with any other report | ||
relating to the same subject matter the office or the attorney | ||
general is required to submit under other law. | ||
[Sections 422.259-422.300 reserved for expansion] | ||
SUBCHAPTER G. PENALTIES | ||
Sec. 422.301. ADMINISTRATIVE OR CIVIL PENALTY; INJUNCTION. | ||
(a) The office may: | ||
(1) act for an agency to which this chapter applies, | ||
including a health and human services agency, in the assessment by | ||
the office of administrative or civil penalties the agency is | ||
authorized to assess under applicable law; and | ||
(2) 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) If the office imposes an administrative or civil penalty | ||
under Subsection (a) 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 2. Section 493.019, Government Code, is amended to | ||
read as follows: | ||
Sec. 493.019. ENFORCEMENT OFFICERS. In accordance with | ||
Section 422.107, the [ |
||
Chapter 422 may appoint employees who are certified by the | ||
Commission on Law Enforcement Officer Standards and Education as | ||
qualified to be peace officers to serve under the direction of the | ||
inspector general and assist the inspector general in performing | ||
the enforcement duties of the department. | ||
SECTION 3. Section 493.028, Government Code, is amended to | ||
read as follows: | ||
Sec. 493.028. INSPECTOR GENERAL REPORT ON CRIMINAL | ||
OFFENSES. (a) In this section, "special prosecution unit" means | ||
the special prosecution unit established under Subchapter E, | ||
Chapter 41. | ||
(b) The inspector general appointed under Chapter 422 [ |
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the board of directors of the special prosecution unit a report | ||
concerning any alleged criminal offense concerning the department | ||
and described by Article 104.003(a), Code of Criminal Procedure, | ||
that occurred during the preceding calendar quarter. | ||
SECTION 4. Section 501.174, Government Code, is amended to | ||
read as follows: | ||
Sec. 501.174. DEPARTMENT TO ADOPT POLICY. The department | ||
shall adopt a policy providing for: | ||
(1) a designated administrator at each correctional | ||
facility to post information throughout the facility describing how | ||
an inmate may confidentially contact the ombudsperson regarding a | ||
sexual assault; | ||
(2) an inmate to write a confidential letter to the | ||
ombudsperson regarding a sexual assault; | ||
(3) employees at correctional facilities, on | ||
notification of the occurrence of a sexual assault, to immediately: | ||
(A) contact the ombudsperson and the office of | ||
the inspector general; and | ||
(B) ensure that the alleged victim is safe; | ||
(4) the office of the inspector general established | ||
under Chapter 422, at the time the office is notified of the sexual | ||
assault, to arrange for a medical examination of the alleged victim | ||
to be conducted in accordance with Article 56.06, Code of Criminal | ||
Procedure, or, if an appropriate employee of the office of the | ||
inspector general is not available at the time the office is | ||
notified of the sexual assault, a qualified employee at the | ||
correctional facility to conduct a medical examination of the | ||
alleged victim in accordance with Article 56.06, Code of Criminal | ||
Procedure; | ||
(5) a grievance proceeding under Section 501.008 based | ||
on an alleged sexual assault to be exempt from any deadline | ||
applicable to grievances initiated under that section; and | ||
(6) each correctional facility to collect statistics | ||
on all alleged sexual assaults against inmates confined in the | ||
facility and to report the statistics to the ombudsperson. | ||
SECTION 5. Section 501.176(b), Government Code, is amended | ||
to read as follows: | ||
(b) The report must include public information regarding: | ||
(1) each investigation and monitoring activity | ||
relating to sexual assault completed during the fiscal year by the | ||
ombudsperson and the inspector general appointed under Chapter 422; | ||
and | ||
(2) statistics collected by the ombudsperson | ||
regarding allegations of sexual assault. | ||
SECTION 6. Section 501.177, Government Code, is amended to | ||
read as follows: | ||
Sec. 501.177. STATE AUDITOR AUDITS, INVESTIGATIONS, AND | ||
ACCESS TO INFORMATION NOT IMPAIRED. This subchapter or other law | ||
related to the operation of the ombudsperson or related to the | ||
office of the inspector general established under Chapter 422 does | ||
not 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. | ||
SECTION 7. Section 501.178, Government Code, is amended to | ||
read as follows: | ||
Sec. 501.178. AUTHORITY OF STATE AUDITOR TO CONDUCT TIMELY | ||
AUDITS NOT IMPAIRED. This subchapter or other law related to the | ||
operation of the ombudsperson or of the office of the inspector | ||
general established under Chapter 422 does not take precedence over | ||
the authority of the state auditor to conduct an audit under Chapter | ||
321 or other law. | ||
SECTION 8. Section 531.001, Government Code, is amended by | ||
adding Subdivision (4-a) to read as follows: | ||
(4-a) "Office of inspector general" means the office | ||
of inspector general established under Chapter 422. | ||
SECTION 9. Section 531.008(c), Government Code, is amended | ||
to read as follows: | ||
(c) The executive commissioner shall establish the | ||
following divisions and offices within the commission: | ||
(1) the eligibility services division to make | ||
eligibility determinations for services provided through the | ||
commission or a health and human services agency related to: | ||
(A) the child health plan program; | ||
(B) the financial assistance program under | ||
Chapter 31, Human Resources Code; | ||
(C) the medical assistance program under Chapter | ||
32, Human Resources Code; | ||
(D) the nutritional assistance programs under | ||
Chapter 33, Human Resources Code; | ||
(E) long-term care services, as defined by | ||
Section 22.0011, Human Resources Code; | ||
(F) community-based support services identified | ||
or provided in accordance with Section 531.02481; and | ||
(G) other health and human services programs, as | ||
appropriate; | ||
(2) [ |
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[ |
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(A) provide dispute resolution services for the | ||
commission and the health and human services agencies; and | ||
(B) perform consumer protection functions | ||
related to health and human services; | ||
(3) [ |
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531.017; and | ||
(4) [ |
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program of internal auditing in accordance with [ |
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Chapter 2102. | ||
SECTION 10. Section 531.1031(a)(2), Government Code, is | ||
amended to read as follows: | ||
(2) "Participating agency" means: | ||
(A) the Medicaid fraud enforcement divisions of | ||
the office of the attorney general; [ |
||
(B) each board or agency with authority to | ||
license, register, regulate, or certify a health care professional | ||
or managed care organization that may participate in the state | ||
Medicaid program; and | ||
(C) the office of inspector general. | ||
SECTION 11. Section 531.104(a), Government Code, is amended | ||
to read as follows: | ||
(a) The office of inspector general [ |
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attorney general shall execute a memorandum of understanding under | ||
which the office [ |
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as required to the attorney general in connection with cases under | ||
Subchapter B, Chapter 36, Human Resources Code. Under the | ||
memorandum of understanding, the office [ |
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in performing preliminary investigations and ongoing | ||
investigations for actions prosecuted by the attorney general under | ||
Subchapter C, Chapter 36, Human Resources Code. | ||
SECTION 12. Section 531.105, Government Code, is amended to | ||
read as follows: | ||
Sec. 531.105. FRAUD DETECTION TRAINING. (a) The office of | ||
inspector general [ |
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program to provide annual training to contractors who process | ||
Medicaid claims and appropriate staff of the health and human | ||
services agencies [ |
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fraud, waste, or abuse under the state Medicaid program. The | ||
training provided to the contractors and staff must include clear | ||
criteria that specify: | ||
(1) the circumstances under which a person should | ||
refer a potential case to the office [ |
||
(2) the time by which a referral should be made. | ||
(b) The commission and other health and human services | ||
agencies [ |
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general [ |
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of potential cases of fraud, waste, or abuse under the state | ||
Medicaid program that each agency will attempt to identify and | ||
refer to the office [ |
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include information on the agencies' goals and the success of each | ||
agency in meeting the agency's goal in the report required by | ||
Section 531.103(c). | ||
SECTION 13. Sections 531.106(a), (b), (d), (e), (f), and | ||
(g), Government Code, are amended to read as follows: | ||
(a) The office of inspector general [ |
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learning or neural network technology to identify and deter fraud, | ||
waste, and abuse in the Medicaid program throughout this state. | ||
(b) The office of inspector general [ |
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contract with a private or public entity to develop and implement | ||
the technology. The office [ |
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contracts with to install and operate the technology at locations | ||
specified by the office [ |
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(d) The office of inspector general [ |
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require each health and human services agency that performs any | ||
aspect of the state Medicaid program to participate in the | ||
implementation and use of the technology. | ||
(e) The office of inspector general [ |
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maintain all information necessary to apply the technology to | ||
claims data covering a period of at least two years. | ||
(f) Cases [ |
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the technology shall be referred to the [ |
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inspector general [ |
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the attorney general, as appropriate. | ||
(g) Each month, the learning or neural network technology | ||
implemented under this section must match bureau of vital | ||
statistics death records with Medicaid claims filed by a provider. | ||
If the commission or the office of inspector general determines | ||
that a provider has filed a claim for services provided to a person | ||
after the person's date of death, as determined by the bureau of | ||
vital statistics death records, [ |
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case shall be referred for investigation to the office of inspector | ||
general or the office of the attorney general, as appropriate [ |
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SECTION 14. Section 531.1061, Government Code, is amended | ||
to read as follows: | ||
Sec. 531.1061. FRAUD INVESTIGATION TRACKING SYSTEM. (a) | ||
The office of inspector general [ |
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fraud investigation tracking system [ |
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of an investigation of suspected fraud, waste, abuse, or | ||
insufficient quality of care under the state Medicaid program. | ||
(b) For each case of suspected fraud, waste, abuse, or | ||
insufficient quality of care identified by the learning or neural | ||
network technology required under Section 531.106, the automated | ||
fraud investigation tracking system must: | ||
(1) receive electronically transferred records | ||
relating to the identified case from the learning or neural network | ||
technology; | ||
(2) record the details and monitor the status of an | ||
investigation of the identified case, including maintaining a | ||
record of the beginning and completion dates for each phase of the | ||
case investigation; | ||
(3) generate documents and reports related to the | ||
status of the case investigation; and | ||
(4) generate standard letters to a provider regarding | ||
the status or outcome of an investigation. | ||
(c) The office of inspector general may [ |
||
require each health and human services agency that performs any | ||
aspect of the state Medicaid program to participate in the | ||
implementation and use of the automated fraud investigation | ||
tracking system. | ||
SECTION 15. Section 531.1062(a), Government Code, is | ||
amended to read as follows: | ||
(a) The office of inspector general [ |
||
an automated recovery monitoring system to monitor the collections | ||
process for a settled case of fraud, waste, abuse, or insufficient | ||
quality of care under the state Medicaid program. | ||
SECTION 16. Sections 531.107(a), (b), and (f), Government | ||
Code, are amended to read as follows: | ||
(a) The Medicaid and Public Assistance Fraud Oversight Task | ||
Force advises and assists the [ |
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office of inspector general [ |
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improving the efficiency of fraud investigations and collections. | ||
(b) The task force is composed of a representative of the: | ||
(1) attorney general's office, appointed by the | ||
attorney general; | ||
(2) comptroller's office, appointed by the | ||
comptroller; | ||
(3) Department of Public Safety, appointed by the | ||
public safety director; | ||
(4) state auditor's office, appointed by the state | ||
auditor; | ||
(5) office of inspector general [ |
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appointed by the inspector general [ |
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(6) [ |
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Services, appointed by the commissioner of aging and disability | ||
[ |
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(7) Texas Department of Insurance, appointed by the | ||
commissioner of insurance; and | ||
(8) [ |
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appointed by the commissioner of state [ |
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(f) At least once each fiscal quarter, the [ |
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office of inspector general [ |
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provide to the task force: | ||
(1) information detailing: | ||
(A) the number of fraud referrals made to the | ||
office and the origin of each referral; | ||
(B) the time spent investigating each case; | ||
(C) the number of cases investigated each month, | ||
by program and region; | ||
(D) the dollar value of each fraud case that | ||
results in a criminal conviction; and | ||
(E) the number of cases the office rejects and | ||
the reason for rejection, by region; and | ||
(2) any additional information the task force | ||
requires. | ||
SECTION 17. Sections 531.108 and 531.109, Government Code, | ||
are amended to read as follows: | ||
Sec. 531.108. FRAUD PREVENTION. (a) [ |
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[ |
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[ |
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[ |
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[ |
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[ |
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[ |
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develop a cost-effective method of identifying applicants for | ||
public assistance in counties bordering other states and in | ||
metropolitan areas selected by the office [ |
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already receiving benefits in other states. If economically | ||
feasible, the office [ |
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matching system. | ||
(b) [ |
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shall: | ||
(1) verify automobile information that is used as | ||
criteria for eligibility; and | ||
(2) establish a computerized matching system with the | ||
Texas Department of Criminal Justice to prevent an incarcerated | ||
individual from illegally receiving public assistance benefits | ||
administered by the commission. | ||
(c) [ |
||
shall submit to the governor and Legislative Budget Board a | ||
semiannual report on the results of computerized matching of office | ||
and commission information with information from neighboring | ||
states, if any, and information from the Texas Department of | ||
Criminal Justice. The report may be consolidated with any other | ||
report relating to the same subject matter the office [ |
||
is required to submit under other law. | ||
Sec. 531.109. SELECTION AND REVIEW OF CLAIMS. (a) The | ||
office of inspector general [ |
||
review a random, statistically valid sample of all claims for | ||
reimbursement under the state Medicaid program, including the | ||
vendor drug program, for potential cases of fraud, waste, or abuse. | ||
(b) In conducting the annual review of claims under | ||
Subsection (a), the office of inspector general [ |
||
directly contact a recipient by telephone or in person, or both, to | ||
verify that the services for which a claim for reimbursement was | ||
submitted by a provider were actually provided to the recipient. | ||
(c) Based on the results of the annual review of claims, the | ||
office of inspector general and the commission shall determine the | ||
types of claims at which office and commission resources for fraud, | ||
waste, and abuse detection should be primarily directed. | ||
SECTION 18. Sections 531.110(a), (c), (d), (e), and (f), | ||
Government Code, are amended to read as follows: | ||
(a) The office of inspector general [ |
||
conduct electronic data matches for a recipient of assistance under | ||
the state Medicaid program at least quarterly to verify the | ||
identity, income, employment status, and other factors that affect | ||
the eligibility of the recipient. | ||
(c) The commission and other health and human services | ||
agencies [ |
||
the office of inspector general [ |
||
any other assistance necessary to conduct the electronic data | ||
matches required by this section. | ||
(d) The office of inspector general [ |
||
contract with a public or private entity to conduct the electronic | ||
data matches required by this section. | ||
(e) The office of inspector general [ |
||
health and human services agency designated by the office | ||
[ |
||
electronic data matches conducted by the office [ |
||
this section. Not later than the 20th day after the date the | ||
electronic data match is verified, the commission and other health | ||
and human services agencies [ |
||
shall remove from eligibility a recipient who is determined to be | ||
ineligible for assistance under the state Medicaid program. | ||
(f) The office of inspector general [ |
||
report biennially to the legislature the results of the electronic | ||
data matching program. The report must include a summary of the | ||
number of applicants who were removed from eligibility for | ||
assistance under the state Medicaid program as a result of an | ||
electronic data match conducted under this section. | ||
SECTION 19. Section 531.111, Government Code, is amended to | ||
read as follows: | ||
Sec. 531.111. FRAUD DETECTION TECHNOLOGY. The office of | ||
inspector general [ |
||
specializes in developing technology capable of identifying | ||
patterns of fraud exhibited by Medicaid recipients to: | ||
(1) develop and implement the fraud detection | ||
technology; and | ||
(2) determine if a pattern of fraud by Medicaid | ||
recipients is present in the recipients' eligibility files | ||
maintained by the commission or other health and human services | ||
agencies [ |
||
SECTION 20. Section 531.1112, Government Code, is amended | ||
to read as follows: | ||
Sec. 531.1112. STUDY CONCERNING INCREASED USE OF TECHNOLOGY | ||
TO STRENGTHEN FRAUD DETECTION AND DETERRENCE; IMPLEMENTATION. (a) | ||
The commission and the [ |
||
shall jointly study the feasibility of increasing the use of | ||
technology to strengthen the detection and deterrence of fraud in | ||
the state Medicaid program. The study must include the | ||
determination of the feasibility of using technology to verify a | ||
person's citizenship and eligibility for coverage. | ||
(b) The commission shall implement any methods the | ||
commission and the [ |
||
determine are effective at strengthening fraud detection and | ||
deterrence. | ||
SECTION 21. Section 531.113, Government Code, is amended to | ||
read as follows: | ||
Sec. 531.113. MANAGED CARE ORGANIZATIONS: SPECIAL | ||
INVESTIGATIVE UNITS OR CONTRACTS. (a) Each managed care | ||
organization that provides or arranges for the provision of health | ||
care services to an individual under a government-funded program, | ||
including the Medicaid program and the child health plan program, | ||
shall: | ||
(1) establish and maintain a special investigative | ||
unit within the managed care organization to investigate fraudulent | ||
claims and other types of program waste or abuse by recipients and | ||
service providers; or | ||
(2) contract with another entity for the investigation | ||
of fraudulent claims and other types of program waste or abuse by | ||
recipients and service providers. | ||
(b) Each managed care organization subject to this section | ||
shall adopt a plan to prevent and reduce fraud, waste, and abuse and | ||
annually file that plan with the [ |
||
general for approval. The plan must include: | ||
(1) a description of the managed care organization's | ||
procedures for detecting and investigating possible acts of fraud, | ||
waste, or abuse; | ||
(2) a description of the managed care organization's | ||
procedures for the mandatory reporting of possible acts of fraud, | ||
waste, or abuse to the [ |
||
(3) a description of the managed care organization's | ||
procedures for educating and training personnel to prevent fraud, | ||
waste, and abuse; | ||
(4) the name, address, telephone number, and fax | ||
number of the individual responsible for carrying out the plan; | ||
(5) a description or chart outlining the | ||
organizational arrangement of the managed care organization's | ||
personnel responsible for investigating and reporting possible | ||
acts of fraud, waste, or abuse; | ||
(6) a detailed description of the results of | ||
investigations of fraud, waste, and abuse conducted by the managed | ||
care organization's special investigative unit or the entity with | ||
which the managed care organization contracts under Subsection | ||
(a)(2); and | ||
(7) provisions for maintaining the confidentiality of | ||
any patient information relevant to an investigation of fraud, | ||
waste, or abuse. | ||
(c) If a managed care organization contracts for the | ||
investigation of fraudulent claims and other types of program waste | ||
or abuse by recipients and service providers under Subsection | ||
(a)(2), the managed care organization shall file with the | ||
[ |
||
(1) a copy of the written contract; | ||
(2) the names, addresses, telephone numbers, and fax | ||
numbers of the principals of the entity with which the managed care | ||
organization has contracted; and | ||
(3) a description of the qualifications of the | ||
principals of the entity with which the managed care organization | ||
has contracted. | ||
(d) The [ |
||
review the records of a managed care organization to determine | ||
compliance with this section. | ||
(e) The inspector general [ |
||
as necessary to accomplish the purposes of this section. | ||
SECTION 22. Sections 531.114(b) and (g), Government Code, | ||
are amended to read as follows: | ||
(b) If after an investigation the office of inspector | ||
general [ |
||
(a), the office [ |
||
(1) notify the person of the alleged violation not | ||
later than the 30th day after the date the office [ |
||
completes the investigation and provide the person with an | ||
opportunity for a hearing on the matter; or | ||
(2) refer the matter to the appropriate prosecuting | ||
attorney for prosecution. | ||
(g) The inspector general [ |
||
necessary to implement this section. | ||
SECTION 23. Section 533.001, Government Code, is amended by | ||
adding Subdivision (3-a) to read as follows: | ||
(3-a) "Inspector general" means the inspector general | ||
appointed under Chapter 422. | ||
SECTION 24. Section 533.005(a), Government Code, is amended | ||
to read as follows: | ||
(a) A contract between a managed care organization and the | ||
commission for the organization to provide health care services to | ||
recipients must contain: | ||
(1) procedures to ensure accountability to the state | ||
for the provision of health care services, including procedures for | ||
financial reporting, quality assurance, utilization review, and | ||
assurance of contract and subcontract compliance; | ||
(2) capitation rates that ensure the cost-effective | ||
provision of quality health care; | ||
(3) a requirement that the managed care organization | ||
provide ready access to a person who assists recipients in | ||
resolving issues relating to enrollment, plan administration, | ||
education and training, access to services, and grievance | ||
procedures; | ||
(4) a requirement that the managed care organization | ||
provide ready access to a person who assists providers in resolving | ||
issues relating to payment, plan administration, education and | ||
training, and grievance procedures; | ||
(5) a requirement that the managed care organization | ||
provide information and referral about the availability of | ||
educational, social, and other community services that could | ||
benefit a recipient; | ||
(6) procedures for recipient outreach and education; | ||
(7) a requirement that the managed care organization | ||
make payment to a physician or provider for health care services | ||
rendered to a recipient under a managed care plan not later than the | ||
45th day after the date a claim for payment is received with | ||
documentation reasonably necessary for the managed care | ||
organization to process the claim, or within a period, not to exceed | ||
60 days, specified by a written agreement between the physician or | ||
provider and the managed care organization; | ||
(8) a requirement that the commission, on the date of a | ||
recipient's enrollment in a managed care plan issued by the managed | ||
care organization, inform the organization of the recipient's | ||
Medicaid certification date; | ||
(9) a requirement that the managed care organization | ||
comply with Section 533.006 as a condition of contract retention | ||
and renewal; | ||
(10) a requirement that the managed care organization | ||
provide the information required by Section 533.012 and otherwise | ||
comply and cooperate with the [ |
||
general; | ||
(11) a requirement that the managed care | ||
organization's usages of out-of-network providers or groups of | ||
out-of-network providers may not exceed limits for those usages | ||
relating to total inpatient admissions, total outpatient services, | ||
and emergency room admissions determined by the commission; | ||
(12) if the commission finds that a managed care | ||
organization has violated Subdivision (11), a requirement that the | ||
managed care organization reimburse an out-of-network provider for | ||
health care services at a rate that is equal to the allowable rate | ||
for those services, as determined under Sections 32.028 and | ||
32.0281, Human Resources Code; | ||
(13) a requirement that the organization use advanced | ||
practice nurses in addition to physicians as primary care providers | ||
to increase the availability of primary care providers in the | ||
organization's provider network; | ||
(14) a requirement that the managed care organization | ||
reimburse a federally qualified health center or rural health | ||
clinic for health care services provided to a recipient outside of | ||
regular business hours, including on a weekend day or holiday, at a | ||
rate that is equal to the allowable rate for those services as | ||
determined under Section 32.028, Human Resources Code, if the | ||
recipient does not have a referral from the recipient's primary | ||
care physician; and | ||
(15) a requirement that the managed care organization | ||
develop, implement, and maintain a system for tracking and | ||
resolving all provider appeals related to claims payment, including | ||
a process that will require: | ||
(A) a tracking mechanism to document the status | ||
and final disposition of each provider's claims payment appeal; | ||
(B) the contracting with physicians who are not | ||
network providers and who are of the same or related specialty as | ||
the appealing physician to resolve claims disputes related to | ||
denial on the basis of medical necessity that remain unresolved | ||
subsequent to a provider appeal; and | ||
(C) the determination of the physician resolving | ||
the dispute to be binding on the managed care organization and | ||
provider. | ||
SECTION 25. Sections 533.012(a), (b), (c), and (e), | ||
Government Code, are amended to read as follows: | ||
(a) Each managed care organization contracting with the | ||
commission under this chapter shall submit to the office of | ||
inspector general [ |
||
(1) a description of any financial or other business | ||
relationship between the organization and any subcontractor | ||
providing health care services under the contract; | ||
(2) a copy of each type of contract between the | ||
organization and a subcontractor relating to the delivery of or | ||
payment for health care services; | ||
(3) a description of the fraud control program used by | ||
any subcontractor that delivers health care services; and | ||
(4) a description and breakdown of all funds paid to | ||
the managed care organization, including a health maintenance | ||
organization, primary care case management, and an exclusive | ||
provider organization, necessary for the office [ |
||
determine the actual cost of administering the managed care plan. | ||
(b) The information submitted under this section must be | ||
submitted in the form required by the office of inspector general | ||
[ |
||
(c) The office [ |
||
[ |
||
submitted under this section as appropriate in the investigation of | ||
fraud in the Medicaid managed care program. | ||
(e) Information submitted to the office of inspector | ||
general [ |
||
not subject to disclosure under Chapter 552[ |
||
SECTION 26. Section 811.001(9), Government Code, is amended | ||
to read as follows: | ||
(9) "Law enforcement officer" means a member of the | ||
retirement system who: | ||
(A) has been commissioned as a law enforcement | ||
officer by the Department of Public Safety, the Texas Alcoholic | ||
Beverage Commission, the Parks and Wildlife Department, or the | ||
office of inspector general at the Texas Youth Commission or its | ||
successor in function; and | ||
(B) is recognized as a commissioned law | ||
enforcement officer by the Commission on Law Enforcement Officer | ||
Standards and Education. | ||
SECTION 27. Section 814.104(b), Government Code, is amended | ||
to read as follows: | ||
(b) A member who is at least 55 years old and who has at | ||
least 10 years of service credit as a commissioned peace officer | ||
engaged in criminal law enforcement activities of the Department of | ||
Public Safety, the Texas Alcoholic Beverage Commission, the Parks | ||
and Wildlife Department, or the office of inspector general at the | ||
Texas Youth Commission or its successor in function, or as a | ||
custodial officer, is eligible to retire and receive a service | ||
retirement annuity. | ||
SECTION 28. Section 815.505, Government Code, is amended to | ||
read as follows: | ||
Sec. 815.505. CERTIFICATION OF NAMES OF LAW ENFORCEMENT AND | ||
CUSTODIAL OFFICERS. Not later than the 12th day of the month | ||
following the month in which a person begins or ceases employment as | ||
a law enforcement officer or custodial officer, the Public Safety | ||
Commission, the Texas Alcoholic Beverage Commission, the Parks and | ||
Wildlife Commission, the office of inspector general at the Texas | ||
Youth Commission or its successor in function, the Board of Pardons | ||
and Paroles, or the Texas Board of Criminal Justice, as applicable, | ||
shall certify to the retirement system, in the manner prescribed by | ||
the system, the name of the employee and such other information as | ||
the system determines is necessary for the crediting of service and | ||
financing of benefits under this subtitle. | ||
SECTION 29. Section 2054.376(b), Government Code, is | ||
amended to read as follows: | ||
(b) This subchapter does not apply to: | ||
(1) the Department of Public Safety's use for criminal | ||
justice or homeland security purposes of a federal database or | ||
network; | ||
(2) a Texas equivalent of a database or network | ||
described by Subdivision (1) that is managed by the Department of | ||
Public Safety; | ||
(3) the uniform statewide accounting system, as that | ||
term is used in Subchapter C, Chapter 2101; | ||
(4) the state treasury cash and treasury management | ||
system; [ |
||
(5) a database or network managed by the comptroller | ||
to: | ||
(A) collect and process multiple types of taxes | ||
imposed by the state; or | ||
(B) manage or administer fiscal, financial, | ||
revenue, and expenditure activities of the state under Chapter 403 | ||
and Chapter 404; or | ||
(6) the use for criminal justice and statutorily | ||
mandated confidentiality purposes of a federal or state database or | ||
network by the office of inspector general established under | ||
Chapter 422. | ||
SECTION 30. Section 21.014(b), Human Resources Code, is | ||
amended to read as follows: | ||
(b) The [ |
||
general appointed under Chapter 422, Government Code, shall make | ||
reports to and consult with the agency director [ |
||
|
||
(1) the selection of internal audit topics; | ||
(2) the establishment of internal audit priorities; | ||
and | ||
(3) the findings of each regular or special internal | ||
audit initiative. | ||
SECTION 31. Section 32.003, Human Resources Code, is | ||
amended by adding Subdivision (5) to read as follows: | ||
(5) "Office of inspector general" means the office of | ||
inspector general established under Chapter 422, Government Code. | ||
SECTION 32. Section 32.0291, Human Resources Code, is | ||
amended to read as follows: | ||
Sec. 32.0291. PREPAYMENT REVIEWS AND POSTPAYMENT HOLDS. | ||
(a) Notwithstanding any other law, the office of inspector general | ||
or department may: | ||
(1) perform a prepayment review of a claim for | ||
reimbursement under the medical assistance program to determine | ||
whether the claim involves fraud, waste, or abuse; and | ||
(2) as necessary to perform that review, withhold | ||
payment of the claim for not more than five working days without | ||
notice to the person submitting the claim. | ||
(b) Notwithstanding any other law, the office of inspector | ||
general [ |
||
future claims submitted by a provider if the office [ |
||
has reliable evidence that the provider has committed fraud, waste, | ||
abuse, or wilful misrepresentation regarding a claim for | ||
reimbursement under the medical assistance program. The office | ||
[ |
||
later than the fifth working day after the date the hold is imposed. | ||
(c) On timely written request by a provider subject to a | ||
postpayment hold under Subsection (b), the office of inspector | ||
general [ |
||
Administrative Hearings for an expedited administrative hearing | ||
regarding the hold. The provider must request an expedited hearing | ||
under this subsection not later than the 10th day after the date the | ||
provider receives notice from the office of inspector general | ||
[ |
||
[ |
||
[ |
||
evidence relied on by the office of inspector general [ |
||
in imposing the hold is relevant, credible, and material to the | ||
issue of fraud, waste, abuse, or wilful misrepresentation. | ||
(d) The inspector general [ |
||
that allow a provider subject to a postpayment hold under | ||
Subsection (b) to seek an informal resolution of the issues | ||
identified by the office of inspector general [ |
||
notice provided under that subsection. A provider must seek an | ||
informal resolution under this subsection not later than the | ||
deadline prescribed by Subsection (c). A provider's decision to | ||
seek an informal resolution under this subsection does not extend | ||
the time by which the provider must request an expedited | ||
administrative hearing under Subsection (c). However, a hearing | ||
initiated under Subsection (c) shall be stayed at the office's | ||
[ |
||
completed. | ||
SECTION 33. Section 32.032, Human Resources Code, is | ||
amended to read as follows: | ||
Sec. 32.032. PREVENTION AND DETECTION OF FRAUD, WASTE, AND | ||
ABUSE. The inspector general [ |
||
rules for minimizing the opportunity for fraud, waste, and abuse, | ||
for establishing and maintaining methods for detecting and | ||
identifying situations in which a question of fraud, waste, or | ||
abuse in the program may exist, and for referring cases where fraud, | ||
waste, or abuse appears to exist to the appropriate law enforcement | ||
agencies for prosecution. | ||
SECTION 34. Sections 32.0321(a), (b), (c), and (d), Human | ||
Resources Code, are amended to read as follows: | ||
(a) The office of inspector general [ |
||
require each provider of medical assistance in a provider type that | ||
has demonstrated significant potential for fraud or abuse to | ||
file with the office [ |
||
amount. The office [ |
||
medical assistance to file with the office [ |
||
bond in a reasonable amount if the office [ |
||
pattern of suspected fraud or abuse involving criminal conduct | ||
relating to the provider's services under the medical assistance | ||
program that indicates the need for protection against potential | ||
future acts of fraud or abuse. | ||
(b) The bond under Subsection (a) must be payable to the | ||
office of inspector general [ |
||
[ |
||
imposed in connection with an act of fraud or abuse committed by the | ||
provider under the medical assistance program. | ||
(c) Subject to Subsection (d) or (e), the office of | ||
inspector general [ |
||
medical assistance that establishes a resident's trust fund account | ||
to post a surety bond to secure the account. The bond must be | ||
payable to the office [ |
||
bonded provider for trust funds that are lost, stolen, or otherwise | ||
unaccounted for if the provider does not repay any deficiency in a | ||
resident's trust fund account to the person legally entitled to | ||
receive the funds. | ||
(d) The office of inspector general [ |
||
require the amount of a surety bond posted for a single facility | ||
provider under Subsection (c) to exceed the average of the total | ||
average monthly balance of all the provider's resident trust fund | ||
accounts for the 12-month period preceding the bond issuance or | ||
renewal date. | ||
SECTION 35. Section 32.0322, Human Resources Code, is | ||
amended to read as follows: | ||
Sec. 32.0322. CRIMINAL HISTORY RECORD INFORMATION. | ||
(a) The office of inspector general and the department may obtain | ||
from any law enforcement or criminal justice agency the criminal | ||
history record information that relates to a provider under the | ||
medical assistance program or a person applying to enroll as a | ||
provider under the medical assistance program. | ||
(b) The office of inspector general [ |
||
shall establish criteria for revoking a provider's enrollment or | ||
denying a person's application to enroll as a provider under the | ||
medical assistance program based on the results of a criminal | ||
history check. | ||
SECTION 36. Section 32.070(d), Human Resources Code, is | ||
amended to read as follows: | ||
(d) This section does not apply to a computerized audit | ||
conducted using the Medicaid Fraud Detection Audit System or an | ||
audit or investigation of fraud, waste, and abuse conducted by the | ||
Medicaid fraud control unit of the office of the attorney general, | ||
the office of the state auditor, the office of [ |
||
general, or the Office of Inspector General in the United States | ||
Department of Health and Human Services. | ||
SECTION 37. Section 33.015(e), Human Resources Code, is | ||
amended to read as follows: | ||
(e) The department shall require a person exempted under | ||
this section from making a personal appearance at department | ||
offices to provide verification of the person's entitlement to the | ||
exemption on initial eligibility certification and on each | ||
subsequent periodic eligibility recertification. If the person | ||
does not provide verification and the department considers the | ||
verification necessary to protect the integrity of the food stamp | ||
program, the department shall initiate a fraud referral to the | ||
[ |
||
Chapter 422, Government Code. | ||
SECTION 38. Section 61.001(7), Human Resources Code, is | ||
amended to read as follows: | ||
(7) "Office of inspector general" means the office of | ||
inspector general established under Chapter 422, Government Code | ||
[ |
||
SECTION 39. Sections 61.0451(a), (d), (f), and (g), Human | ||
Resources Code, are amended to read as follows: | ||
(a) The office of inspector general shall investigate [ |
||
|
||
(1) crimes committed by commission employees, | ||
including parole officers employed by or under a contract with the | ||
commission; and | ||
(2) crimes and delinquent conduct committed at a | ||
facility operated by the commission, a residential facility | ||
operated by another entity under a contract with the commission, or | ||
any facility in which a child committed to the custody of the | ||
commission is housed or receives medical or mental health | ||
treatment. | ||
(d) The office of inspector general may employ and | ||
commission inspectors [ |
||
with Section 422.107, Government Code, for the purpose of carrying | ||
out the duties described by this section. An inspector [ |
||
shall have all of the powers and duties given to peace officers | ||
under Article 2.13, Code of Criminal Procedure. | ||
(f) If the inspector general is not a commissioned peace | ||
officer, the inspector general [ |
||
select a commissioned peace officer as chief inspector [ |
||
The chief inspector [ |
||
this section and may only be discharged for cause. | ||
(g) The [ |
||
prepare and deliver a report concerning the operations of the | ||
office of inspector general to: | ||
(1) the executive commissioner; | ||
(2) the advisory board; | ||
(3) the governor; | ||
(4) the lieutenant governor; | ||
(5) the speaker of the house of representatives; | ||
(6) the standing committees of the senate and house of | ||
representatives with primary jurisdiction over correctional | ||
facilities; | ||
(7) the state auditor; and | ||
(8) the comptroller. | ||
SECTION 40. Sections 61.098(d) and (e), Human Resources | ||
Code, are amended to read as follows: | ||
(d) Notwithstanding Subsection (c), the office of inspector | ||
general shall immediately provide the special prosecution unit with | ||
a report concerning an alleged criminal offense or delinquent | ||
conduct concerning the commission and described by Article | ||
104.003(a), Code of Criminal Procedure, if the [ |
||
general reasonably believes the offense or conduct is particularly | ||
serious and egregious. | ||
(e) The [ |
||
general, at the direction of the board of directors of the special | ||
prosecution unit, shall notify the foreman of the appropriate grand | ||
jury, in the manner provided by Article 20.09, Code of Criminal | ||
Procedure, if: | ||
(1) the [ |
||
evidence of illegal or improper conduct by commission officers, | ||
employees, or contractors that the inspector general reasonably | ||
believes jeopardizes the health, safety, and welfare of children in | ||
the custody of the commission; | ||
(2) the [ |
||
the conduct: | ||
(A) could constitute an offense under Article | ||
104.003(a), Code of Criminal Procedure; and | ||
(B) involves the alleged physical or sexual abuse | ||
of a child in the custody of a commission facility or an | ||
investigation related to the alleged abuse; and | ||
(3) the [ |
||
believe that information concerning the conduct has not previously | ||
been presented to the appropriate grand jury. | ||
SECTION 41. Section 64.055(b), Human Resources Code, is | ||
amended to read as follows: | ||
(b) The independent ombudsman shall immediately report to | ||
the governor, the lieutenant governor, the speaker of the house of | ||
representatives, the state auditor, and the office of the inspector | ||
general established under Chapter 422, Government Code, [ |
||
|
||
(1) case of abuse or injury of a child committed to the | ||
commission; | ||
(2) problem concerning the administration of a | ||
commission program or operation; | ||
(3) problem concerning the delivery of services in a | ||
facility operated by or under contract with the commission; or | ||
(4) interference by the commission with an | ||
investigation conducted by the office. | ||
SECTION 42. Section 64.056(b), Human Resources Code, is | ||
amended to read as follows: | ||
(b) The records of the independent ombudsman are | ||
confidential, except that the independent ombudsman shall: | ||
(1) share with the office of inspector general | ||
established under Chapter 422, Government Code, [ |
||
a communication with a child that may involve the abuse or neglect | ||
of the child; and | ||
(2) disclose its nonprivileged records if required by | ||
a court order on a showing of good cause. | ||
SECTION 43. 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 [ |
||
|
||
in state agencies under Chapter 422, Government Code, or other law | ||
[ |
||
(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 44. 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 [ |
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under Section [ |
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(30) [ |
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[ |
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on Law Enforcement Officer Standards and Education under Section | ||
1701.160, Occupations Code; | ||
(31) [ |
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the Texas Private Security Board under Section 1702.061(f), | ||
Occupations Code; | ||
(32) [ |
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inspectors, or investigators commissioned by an emergency services | ||
district under Chapter 775, Health and Safety Code; | ||
(33) [ |
||
of Dental Examiners under Section 254.013, Occupations Code, | ||
subject to the limitations imposed by that section; | ||
(34) [ |
||
Juvenile Probation Commission as officers under Section 141.055, | ||
Human Resources Code; [ |
||
(35) [ |
||
inspectors, or investigators commissioned by a county under | ||
Subchapter B, Chapter 352, Local Government Code; and | ||
(36) officers commissioned by the office of inspector | ||
general established under Chapter 422, Government Code. | ||
SECTION 45. The following sections of the Government Code | ||
are repealed: | ||
(1) Section 531.102; | ||
(2) Section 531.1021; and | ||
(3) Section 531.103. | ||
SECTION 46. (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 47. (a) The person serving as inspector general | ||
under Section 531.102(a-1), Government Code, on the effective date | ||
of this Act shall serve as the inspector general appointed under | ||
Chapter 422, Government Code, as added by this Act, until February | ||
1, 2013, and may be reappointed under Chapter 422 if the person has | ||
the qualifications required under that chapter. | ||
(b) 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. | ||
(c) Not later than February 1, 2013, 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, 2015. | ||
SECTION 48. 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 49. (a) All personnel and assets currently | ||
assigned to the inspector general of a state 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, 2009; | ||
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, 2010. | ||
(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 50. 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 51. (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 52. 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. | ||
SECTION 53. This Act takes effect immediately if it | ||
receives a vote of two-thirds of all the members elected to each | ||
house, as provided by Section 39, Article III, Texas Constitution. | ||
If this Act does not receive the vote necessary for immediate | ||
effect, this Act takes effect September 1, 2011. |