Sec. 531.108. FRAUD PREVENTION. (a) The commission's office of inspector general shall compile and disseminate accurate information and statistics relating to:
(1) fraud prevention; and
(2) post-fraud referrals received and accepted or rejected from the commission's case management system or the case management system of a health and human services agency.
(b) The commission shall:
(1) aggressively publicize successful fraud prosecutions and fraud-prevention programs through all available means, including the use of statewide press releases; and
(2) ensure that a toll-free hotline for reporting suspected fraud in programs administered by the commission or a health and human services agency is maintained and promoted, either by the commission or by a health and human services agency.
(c) The commission shall develop a cost-effective method of identifying applicants for public assistance in counties bordering other states and in metropolitan areas selected by the commission who are already receiving benefits in other states. If economically feasible, the commission may develop a computerized matching system.
(d) The commission 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.
(e) Not later than October 1 of each year, the commission shall submit to the governor and Legislative Budget Board an annual report on the results of computerized matching of 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 commission is required to submit under other law.
Added by Acts 1997, 75th Leg., ch. 1153, Sec. 1.06(a), eff. Sept. 1, 1997.
Amended by:
Acts 2013, 83rd Leg., R.S., Ch. 1312 (S.B. 59), Sec. 38, eff. September 1, 2013.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.144, eff. April 2, 2015.
Acts 2021, 87th Leg., R.S., Ch. 856 (S.B. 800), Sec. 8, eff. September 1, 2021.
Structure Texas Statutes
Subtitle I - Health and Human Services
Chapter 531 - Health and Human Services Commission
Subchapter C. Medicaid and Other Health and Human Services Fraud, Abuse, or Overcharges
Section 531.101. Award for Reporting Medicaid Fraud, Abuse, or Overcharges
Section 531.102. Office of Inspector General
Section 531.1022. Peace Officers
Section 531.1023. Compliance With Federal Coding Guidelines
Section 531.1024. Hospital Utilization Reviews and Audits: Provider Education Process
Section 531.1025. Performance Audits and Coordination of Audit Activities
Section 531.103. Interagency Coordination
Section 531.1031. Duty to Exchange Information
Section 531.1032. Office of Inspector General: Criminal History Record Information Check
Section 531.1033. Monitoring of Certain Federal Databases
Section 531.1034. Time to Determine Provider Eligibility; Performance Metrics
Section 531.104. Assisting Investigations by Attorney General
Section 531.105. Fraud Detection Training
Section 531.106. Learning, Neural Network, or Other Technology
Section 531.1061. Fraud Investigation Tracking System
Section 531.1062. Recovery Monitoring System
Section 531.108. Fraud Prevention
Section 531.1081. Integrity of Certain Public Assistance Programs
Section 531.109. Selection and Review of Claims
Section 531.110. Electronic Data Matching Program
Section 531.111. Fraud Detection Technology
Section 531.113. Managed Care Organizations: Special Investigative Units or Contracts
Section 531.1131. Fraud and Abuse Recovery by Certain Persons; Retention of Recovered Amounts
Section 531.1132. Annual Report on Certain Fraud and Abuse Recoveries
Section 531.1135. Managed Care Organizations: Process to Recoup Certain Overpayments
Section 531.114. Financial Assistance Fraud
Section 531.115. Federal Felony Match
Section 531.116. Compliance With Law Prohibiting Solicitation
Section 531.117. Recovery Audit Contractors
Section 531.118. Preliminary Investigations of Allegations of Fraud or Abuse and Fraud Referrals
Section 531.119. Website Posting
Section 531.120. Notice and Informal Resolution of Proposed Recoupment of Overpayment or Debt
Section 531.1201. Appeal of Determination to Recoup Overpayment or Debt
Section 531.1202. Record and Confidentiality of Informal Resolution Meetings
Section 531.1203. Rights of and Provision of Information to Pharmacies Subject to Certain Audits