Texas Statutes
Subchapter C. Medicaid and Other Health and Human Services Fraud, Abuse, or Overcharges
Section 531.108. Fraud Prevention

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

Texas Statutes

Government Code

Title 4 - Executive Branch

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 531.1011. Definitions

Section 531.102. Office of Inspector General

Section 531.1021. Subpoenas

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 531.1112. Study Concerning Increased Use of Technology to Strengthen Fraud Detection and Deterrence; Implementation

Section 531.112. Expunction of Information Related to Certain Chemical Dependency Diagnoses in Certain Records

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