Texas Statutes
Subchapter C. Medicaid and Other Health and Human Services Fraud, Abuse, or Overcharges
Section 531.1081. Integrity of Certain Public Assistance Programs

Sec. 531.1081. INTEGRITY OF CERTAIN PUBLIC ASSISTANCE PROGRAMS. (a) In this section:
(1) "Financial assistance benefits" means money payments under the federal Temporary Assistance for Needy Families program operated under Chapter 31, Human Resources Code, or under the state temporary assistance and support services program operated under Chapter 34, Human Resources Code.
(2) "Supplemental nutrition assistance benefits" means money payments under the supplemental nutrition assistance program operated under Chapter 33, Human Resources Code.
(b) To the extent not otherwise provided by this subtitle or Title 2, Human Resources Code, the commission shall develop and implement, in accordance with this section, methods for reducing abuse, fraud, and waste in public assistance programs.
(c) On a monthly basis, the commission shall:
(1) conduct electronic data matches with the Texas Lottery Commission to determine if a recipient of supplemental nutrition assistance benefits or a recipient's household member received reportable lottery winnings;
(2) use the database system developed under Section 531.0214 to match vital statistics unit death records with a list of individuals eligible for financial assistance or supplemental nutrition assistance benefits, and ensure that any individual receiving assistance under either program who is discovered deceased has their eligibility for assistance promptly terminated; and
(3) review the out-of-state electronic benefit transfer card transactions made by a recipient of supplemental nutrition assistance benefits to determine whether those transactions indicate a possible change in the recipient's residence.
(d) The commission shall immediately review the eligibility of a recipient of public assistance benefits if the commission discovers information under this section that affects the recipient's eligibility.
(e) A recipient who fails to disclose lottery winnings that are required to be reported to the commission under a public assistance program presumptively commits a program violation.
(f) The executive commissioner shall adopt rules necessary to implement this section.
Added by Acts 2021, 87th Leg., R.S., Ch. 879 (S.B. 1341), Sec. 1, 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