Texas Statutes
Subchapter C. Medicaid and Other Health and Human Services Fraud, Abuse, or Overcharges
Section 531.110. Electronic Data Matching Program

Sec. 531.110. ELECTRONIC DATA MATCHING PROGRAM. (a) In this section, "public assistance program" includes:
(1) Medicaid;
(2) the financial assistance program under Chapter 31, Human Resources Code; and
(3) a nutritional assistance program under Chapter 33, Human Resources Code, including the supplemental nutrition assistance program under that chapter.
(a-1) The commission shall conduct electronic data matches for a recipient of benefits under a public assistance program at least quarterly to verify the identity, income, employment status, and other factors that affect the eligibility of the recipient.
(b) To verify eligibility of a recipient of public assistance program benefits, the electronic data matching must match information provided by the recipient with information contained in databases maintained by appropriate federal and state agencies.
(c) The health and human services agencies shall cooperate with the commission by providing data or any other assistance necessary to conduct the electronic data matches required by this section.
(c-1) The commission shall enter into a memorandum of understanding with each state agency from which data is required to conduct electronic data matches under this section and Section 531.1081.
(d) The commission may contract with a public or private entity to conduct the electronic data matches required by this section.
(e) The executive commissioner shall establish procedures by which the commission, or a health and human services agency designated by the commission, verifies the electronic data matches conducted by the commission under this section. Not later than the 20th day after the date the electronic data match is verified, the commission shall remove from eligibility a recipient who is determined to be ineligible for a public assistance program.
(f) Repealed by Acts 2011, 82nd Leg., R.S., Ch. 1083, Sec. 25(59), eff. June 17, 2011.
Added by Acts 1999, 76th Leg., ch. 1289, Sec. 4, eff. Sept. 1, 1999.
Amended by:
Acts 2011, 82nd Leg., R.S., Ch. 1050 (S.B. 71), Sec. 21(8), eff. September 1, 2011.
Acts 2011, 82nd Leg., R.S., Ch. 1083 (S.B. 1179), Sec. 25(59), eff. June 17, 2011.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.146, eff. April 2, 2015.
Acts 2021, 87th Leg., R.S., Ch. 879 (S.B. 1341), Sec. 2, 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