By: Herrero H.B. No. 4665
A BILL TO BE ENTITLED
AN ACT
relating to the office of inspector general for the Health and Human
Services Commission.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 531, Government Code, is amended by
adding Subchapter R to read as follows:
SUBCHAPTER R. INSPECTOR GENERAL
Sec. 531.701. DEFINITIONS. In this subchapter:
(1) "Fraud" has the meaning assigned by Section
531.1011.
(2) "Inspector general" means the inspector general
appointed under this subchapter.
(3) "Office" means the Office of Inspector General.
(4) "Provider" has the meaning assigned by Section
531.1011.
(5) "Review" includes an inspection, investigation,
audit, or similar activity.
(6) "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. 531.702. REFERENCE IN OTHER LAW. Notwithstanding any
other provision of law, a reference in law or rule to the
commission's office of inspector general or the commission's office
of investigations and enforcement means the Office of Inspector
General.
Sec. 531.703. OFFICE OF INSPECTOR GENERAL; ADMINISTRATIVE
ATTACHMENT. (a) The office of inspector general 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 investigation, prevention and detection of
crime relating to the provision of those services.
(b) The office is part of the single state Medicaid agency
and is administratively attached to the commission. The commission
shall provide to the office administrative support services from
the commission and from health and human services agencies.
Sec. 531.704. SERVICE LEVEL AGREEMENT; FUNDS. (a) The
commission and the office shall enter into a service level
agreement that establishes the performance standards and
deliverables with regard to administrative support by the
commission.
(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 request, apply for, and receive for
the office any appropriations or other money from this state or the
federal government, and shall disburse all such funds to the office
as appropriated.
(d) The commission shall provide to the office for the state
fiscal biennium beginning September 1, 2009, 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, 2007. This subsection expires
January 1, 2012.
Sec. 531.705. DUTIES OF COMMISSION. (a) The commission
shall:
(1) provide administrative assistance to the office;
and
(2) coordinate administrative responsibilities with
the office to avoid unnecessary duplication of duties.
(b) The commission may not take an action that affects or
relates to the validity, status, or terms of an interagency
agreement or a contract to which the office is a party without the
office's approval.
Sec. 531.706. INDEPENDENCE OF OFFICE. (a) Except as
otherwise provided by this chapter, the office and inspector
general operate independently of the commission.
(b) The inspector general, not the executive commissioner,
supervises the office staff and manages the operations of the
office.
(c) The inspector general shall have operational authority
over and responsibility for the:
(1) management of the daily operations of the office,
including the organization and management of the office and office
operating procedures;
(2) allocation of resources within the office;
(3) personnel and employment policies;
(4) contracting, purchasing, and related policies,
subject to other laws relating to state agency contracting and
purchasing;
(5) information resources systems used by the office;
(6) location of office facilities;
(7) coordination of office activities with activities
of other state agencies, including other health and human services
agencies.
Sec. 531.707. INSPECTOR GENERAL; APPOINTMENT AND TERM. (a)
The governor shall appoint an inspector general to serve as
director of the office.
(b) The inspector general reports to the governor and serves
a two-year term that expires on February 1 of each odd-numbered
year.
(c) The inspector general is a state officer.
Section 531.708. 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, a health and human services
agency, or a health or human services provider.
Section 531.709. 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, as well as rules
relating to the eligibility of providers and contractors to
participate in health and human services programs.
(b) A rule, standard, or form adopted by the executive
commissioner, the commission, or a health and human services agency
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 office may submit proposed rules and adopted rules
to the commission for publication. The executive commissioner or
commission may not amend or modify a rule submitted by the office.
(d) 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. 531.710. EMPLOYEES; MEDICAL REVIEW OFFICER; TRAINING.
(a) The inspector general may employ personnel as necessary
to implement the duties of the office.
(b) The inspector general shall employ a physician as the
medical review officer to perform reviews and provide information
and consultation as appropriate when the matter at issue involves
or requires medical expertise.
(c) The inspector general shall train office personnel to
pursue priority Medicaid and other health and human services fraud,
waste, and abuse cases efficiently and as necessary.
(d) The inspector general may contract with certified
public accountants, management consultants, or other professional
experts necessary to enable the inspector general and office
personnel to independently perform the functions of the inspector
general's office.
(e) The inspector general may require employees of health
and human services agencies 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 health and human
services.
Sec. 531.711. REVIEW AUTHORITY. (a) The inspector general
may review any activity or operation of a health and human services
agency, health or human services provider, or person in this state
that is related to the investigation, detection, or prevention of
fraud, waste, or abuse, or official or employee misconduct, in a
state or state-funded health or human services program. A review
may include an inspection, investigation, audit, or other similar
activity inquiring 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 money.
(b) The executive commissioner, the commission, or a health
and human services agency of this state may not impair, prohibit, or
attempt to influence the inspector general in initiating,
conducting, or completing a review.
(c) The inspector general may conduct reviews, including
financial or performance audits regarding the use and effectiveness
of state funds, including contract and grant funds, administered by
a person or state agency receiving the funds in connection with a
state or state-funded health or human services program.
Sec. 531.712. INITIATION OF REVIEW. The inspector general
may initiate a review:
(1) on the inspector general's own initiative;
(2) at the request of the commission or executive
commissioner; or
(3) based on a complaint from any source concerning a
matter described by Section 531.711.
Sec. 531.713. INTEGRITY REVIEW. (a) The office 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 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. 531.714. ACCESS TO INFORMATION. (a) To further a
review conducted by the office, the inspector general is entitled
to full and unrestricted access to all offices, limited-access or
restricted areas, employees, books, papers, records, documents,
equipment, computers, databases, systems, accounts, reports,
vouchers, or other information, including confidential
information, electronic data, and internal records relevant to the
functions of the office, maintained by a person, health and human
services agency, or health or human services provider in connection
with a state or state-funded health or human services program.
(b) The inspector general may not access data or other
information the release of which is restricted under federal law
unless the office is in compliance with all applicable federal
regulations governing such access.
Sec. 531.715. COOPERATION REQUIRED. To further a review
conducted by the inspector general's office, the inspector general
may require medical or other professional assistance from the
executive commissioner, the commission, a health and human services
agency, or an auditor, accountant, or other employee of the
commission or agency.
Sec. 531.716. 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. 531.717. 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 state or state-funded 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 office of the attorney general are entitled to intervene as
parties in the contested case.
Sec. 531.718. REQUEST FOR EXPEDITED HEARING. (a) On timely
written request by a health or human services provider subject to a
hold on payment under Section 531.717, 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 Hearing 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 531.717(b).
(c) The office may enter into a memorandum of understanding
with the State Office of Administrative Hearings to facilitate the
docketing and hearing of contested case hearings.
Sec. 531.719. 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 531.717, 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 must seek an
informal resolution not later than the 10th day after the date the
provider receives notice from the office under Section 531.717(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 531.718.
(d) A hearing initiated under Section 531.717 shall be
stayed at the office's request until the informal resolution
process is completed.
Sec. 531.720. EMPLOYEE REPORTS. The inspector general may
require employees at the commission or a health and human services
agency to report to the office information regarding fraud, waste,
misuse or abuse of funds or resources, corruption, or illegal acts.
Sec. 531.721. SUBPOENAS. (a) The inspector general may
issue a subpoena to compel the attendance of a relevant witness or
the production, for inspection or copying, of relevant evidence in
connection with a review 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. 531.722. INTERNAL AUDITOR. (a) In this section,
"internal auditor" means a person appointed under Section 2102.006.
(b) The internal auditor for a health and human services
agency 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. 531.723. 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 office of the attorney general, to assist in
conducting a review under this subchapter.
Sec. 531.724. 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 531.714 or subject to Section 531.731.
(d) Any information obtained or provided by the state
auditor under this section is confidential and not subject to
disclosure under Chapter 552.
Sec. 531.725. PREVENTION. (a) The inspector general may
recommend to the commission and executive commissioner policies on:
(1) promoting economical and efficient administration
of state funds administered by an individual or entity that
received the funds from a health and human services 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, or abuse to
employees of a health and human services agency. The training or
education provided must be approved by the presiding officer of the
agency.
Sec. 531.726. RULEMAKING BY EXECUTIVE COMMISSIONER. The
executive commissioner may adopt rules governing a health and human
services 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. 531.727. ALLEGATIONS OF MISCONDUCT AGAINST PRESIDING
OFFICER. If a review by the inspector general involves allegations
that a presiding officer of a health and human services 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.
Sec. 531.728. PERIODIC REPORTING TO STATE AUDITOR AND
EXECUTIVE COMMISSIONER REQUIRED. The inspector general shall
timely inform the state auditor and the executive commissioner of
the initiation of a review of a health and human services agency
program and the ongoing status of each review.
Sec. 531.729. REPORTING OFFICE FINDINGS. The inspector
general shall report the findings of any review or investigation
conducted by the office to:
(1) the executive commissioner;
(2) the governor;
(3) the lieutenant governor;
(4) the speaker of the house of representatives;
(5) the state auditor 's office; and
(6) appropriate law enforcement and prosecutorial
agencies, including the office of the attorney general, if the
findings suggest the probability of criminal conduct.
Sec. 531.730. FLAGRANT VIOLATIONS; IMMEDIATE REPORT. The
inspector general shall immediately report to the executive
commissioner, the governor's general counsel, and the state auditor
a problem deemed by the inspector general to be particularly
serious or flagrant, and relating to the administration of a
program, operation of a health and human services agency, or
interference with an inspector general review.
Sec. 531.731. INFORMATION CONFIDENTIAL. (a) Except as
provided by this section, Sections 531.103, 531.729, and 531.733,
all information and material compiled or maintained by the
inspector general during a review under this subchapter 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 commission, or the office or its agents
involved in the review related to that information or material.
(b) Subsection (a) applies to information the inspector
general is required to disclose under Sections 531.727, 531.728,
531.730, and 531.732.
(c) As the inspector general determines appropriate based
on evidence sufficient to support an allegation, information
relating to a review may be disclosed to:
(1) a law enforcement agency;
(2) the attorney general's office;
(3) the state auditor's office; or
(4) the commission.; or
(5) a licensing or regulatory agency.
(d) A person that receives information under Subsections
(b) and (c) may not disclose the information except to the extent
that disclosure is consistent with the authorized purpose for which
the person first obtained the information.
Sec. 531.732. DRAFT OF FINAL REPORT; AGENCY RESPONSE.
(a) Except in cases in which the office has determined that
potential fraud, waste, or abuse exists, or a criminal violation
has occurred, the office shall provide a draft of the final report
of any review of the operations of a health and human services
agency to the presiding officer of the agency before publishing the
office's final report.
(b) The health and human services agency 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 and requirements of 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. 531.733. FINAL REVIEW REPORTS; AGENCY RESPONSE. (a)
The inspector general shall prepare a final report for each review
conducted under this subchapter. 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, a health and human services 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. 531.734. 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 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. 531.735. AUTHORITY OF STATE AUDITOR TO CONDUCT TIMELY
AUDITS NOT IMPAIRED. This chapter or other law related to the
operation of the inspector general does not take precedence over
the authority of the state auditor to conduct an audit under Chapter
321 or other law.
Sec. 531.736. BUDGET. (a) The inspector general shall
submit a budget in accordance with the reporting requirements of
the General Appropriations Act.
(b) The inspector general shall submit to the commission a
legislative appropriations request and an operating budget in
accordance with the service level agreement entered into under
Section 531.704 and applicable law.
(c) The commission shall submit the office's appropriations
request and, if required by or under law, operating budget to the
legislature. The request or budget is not subject to review,
alteration, or modification by the commission or executive
commissioner before submission to the legislature.
Sec. 531.737. 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 office of
the attorney general, in recovering costs incurred under this
subchapter from nongovernmental entities, including contractors or
individuals involved in:
(1) violations of applicable state or federal rules or
statutes;
(2) abusive or willful misconduct; or
(3) violations of a provider contract or program
policy.
(c) In criminal cases the inspector general and the Office
of Attorney General shall cooperate to ensure that all appropriate
evidence is submitted to the court in all criminal prosecutions
towards ensuring that restitution is ordered, to include the
overpayment and the costs incurred under this subchapter, as a
condition of probation or as a condition of parole.
Sec. 531.738. ADMINISTRATIVE OR CIVIL PENALTY; INJUNCTION.
(a) The office may:
(1) act for 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 a health and human services agency:
(1) the health and human services 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 subchapter, and applicable
laws and rules governing the imposition of a penalty by the health
and human services agency.
Sec. 531.739. PEACE OFFICER INVESTIGATORS. (a) An
investigator assigned to conduct investigations for the office may
be a commissioned peace officer. The number of commissioned peace
officers assigned to conduct investigations may not exceed 15
percent of the office's full-time equivalent positions.
(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.
SECTION 2. 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 Subchapter R.
SECTION 3. 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) [the office of inspector general to perform fraud
and abuse investigation and enforcement functions as provided by
Subchapter C and other law;
[(3)] the office of the ombudsman to:
(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) [(4)] a purchasing division as provided by Section
531.017; and
(4) [(5)] an internal audit division to conduct a
program of internal auditing in accordance with [Government Code,]
Chapter 2102.
SECTION 4. Sections 531.103(a), (c), and (d), Government
Code, are amended to read as follows:
(a) The [commission, acting through the commission's]
office of inspector general[,] and the office of 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 the state Medicaid program or other program administered by
the commission or a health and human services agency, including the
financial assistance program under Chapter 31, Human Resources
Code, a nutritional assistance program under Chapter 33, Human
Resources Code, and the child health plan program. The memorandum
of understanding shall require:
(1) the office of inspector general and the office of
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 maximize the imposition of penalties, the recovery of
money, and the successful prosecution of cases;
(1-a) the office of inspector general to refer each
case of suspected provider fraud, waste, or abuse to the office of
the attorney general not later than the 20th business day after the
date the office of inspector general determines that the existence
of fraud, waste, or abuse is reasonably indicated;
(1-b) the office of 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 collections agency for initiation
of civil litigation or other appropriate action;
(2) the office of inspector general to keep detailed
records for cases processed by that office or the office of 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;
(3) the office of inspector general to notify each
appropriate division of the office of the attorney general of each
case referred by the office of inspector general;
(4) the office of the attorney general to ensure that
information relating to each case investigated by that office is
available to each division of the office with responsibility for
investigating suspected fraud, waste, or abuse;
(5) the office of the attorney general to notify the
office of inspector general of each case the attorney general
declines to prosecute or prosecutes unsuccessfully;
(6) representatives of the office of inspector general
and of the office of 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
(7) the office of inspector general and the office of
the attorney general to submit information requested by the
comptroller about each resolved case for the comptroller's use in
improving fraud detection.
(c) The office of inspector general [commission] and the
office of the attorney general shall jointly prepare and submit a
semiannual report to the governor, lieutenant governor, speaker of
the house of representatives, and comptroller concerning the
activities of the office of the attorney general and the office of
inspector general [those agencies] in detecting and preventing
fraud, waste, and abuse under the state Medicaid program or other
program administered by the commission or a health and human
services agency. The report may be consolidated with any other
report relating to the same subject matter the office of inspector
general [commission] or office of the attorney general is required
to submit under other law.
(d) The office of inspector general [commission] and the
office of the attorney general may not assess or collect
investigation and attorney's fees on behalf of any state agency
unless the office of inspector general, the office of the attorney
general, or another [other] state agency collects a penalty,
restitution, or other reimbursement payment to the state.
SECTION 5. 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; [and]
(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 6. Section 531.104(a), Government Code, is amended
to read as follows:
(a) The office of inspector general [commission] and the
attorney general shall execute a memorandum of understanding under
which the office [commission] shall provide investigative support
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 [commission] shall assist
in performing preliminary investigations and ongoing
investigations for actions prosecuted by the attorney general under
Subchapter C, Chapter 36, Human Resources Code.
SECTION 7. Section 531.105, Government Code, is amended to
read as follows:
Sec. 531.105. FRAUD DETECTION TRAINING. [(a)] The office
of inspector general [commission] shall develop and implement a
program to provide annual training to contractors who process
Medicaid claims and appropriate staff of the health and human
services agencies [Texas Department of Health and the Texas
Department of Human Services] in identifying potential cases of
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 [commission]; and
(2) the time by which a referral should be made.
[(b) The Texas Department of Health and the Texas Department
of Human Services, in cooperation with the commission, shall
periodically set a goal of the number of potential cases of fraud,
waste, or abuse under the state Medicaid program that each agency
will attempt to identify and refer to the commission. The
commission shall 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 8. Sections 531.106(f) and (g), Government Code,
are amended to read as follows:
(f) Cases [The commission shall refer cases] identified by
the technology shall be referred to the [commission's] office of
inspector general [investigations and enforcement] or the office of
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, [the commission shall refer] the
case shall be referred for investigation to the office of inspector
general or the office of the attorney general, as appropriate [to
the commission 's office of investigations and enforcement].
SECTION 9. Section 531.1061, Government Code, is amended to
read as follows:
Sec. 531.1061. FRAUD INVESTIGATION TRACKING SYSTEM. (a)
The office of inspector general [commission] shall use an automated
fraud investigation tracking system [through the commission's
office of investigations and enforcement] to monitor the progress
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) Each [The commission shall require each] health and
human services agency that performs any aspect of the state
Medicaid program shall [to] participate in the implementation and
use of the automated fraud investigation tracking system as
directed by the office.
SECTION 10. Section 531.1062(a), Government Code, is
amended to read as follows:
(a) The office of inspector general [commission] shall use
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 11. Sections 531.107(a) and (f), Government Code,
are amended to read as follows:
(a) The Medicaid and Public Assistance Fraud Oversight Task
Force advises and assists the [commission and the commission's]
office of inspector general [investigations and enforcement] in
improving the efficiency of fraud investigations and collections.
(f) At least once each fiscal quarter, the [commission's]
office of inspector general [investigations and enforcement] shall
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 12. Sections 531.108 and 531.109, Government Code,
are amended to read as follows:
Sec. 531.108. FRAUD PREVENTION. (a) The [commission's]
office of inspector general [investigations and enforcement] 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 office 's [commission's] case management system
or the case management system of a health and human services agency.
(b) The office of inspector general [commission] shall[:
[(1)] aggressively publicize successful fraud prosecutions
and fraud-prevention programs through all available means,
including the use of statewide press releases [issued in
coordination with the Texas Department of Human Services; 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 office of inspector general [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 office [commission] who are
already receiving benefits in other states. If economically
feasible, the office [commission] may develop a computerized
matching system.
(d) The office of inspector general [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) The office of inspector general [commission] 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 [commission] is
required to submit under other law.
Sec. 531.109. SELECTION AND REVIEW OF CLAIMS. (a) The
office of inspector general [commission] shall annually select and
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 [commission] may
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 13. Sections 531.110(a), (c), (d), (e), and (f),
Government Code, are amended to read as follows:
(a) The office of inspector general [commission] shall
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 [Texas Department of Human Services] shall cooperate with
the office of inspector general [commission] by providing data or
any other assistance necessary to conduct the electronic data
matches required by this section.
(d) The office of inspector general [commission] may
contract with a public or private entity to conduct the electronic
data matches required by this section.
(e) The office of inspector general [commission], or a
health and human services agency designated by the office
[commission], by rule shall establish procedures to verify the
electronic data matches conducted by the office [commission] under
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 [Texas Department of Human Services]
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 [commission] shall
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 14. 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 [commission's] office of inspector general
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 [commission's] office of inspector general
determine are effective at strengthening fraud detection and
deterrence.
SECTION 15. 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 [commission's] office of inspector
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 [commission's] office of inspector general;
(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
[commission's] office of inspector general:
(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 [commission's] office of inspector general may
review the records of a managed care organization to determine
compliance with this section.
(e) The inspector general [commissioner] shall adopt rules
as necessary to accomplish the purposes of this section.
SECTION 16. Sections 531.114(b) and (g), Government Code,
are amended to read as follows:
(b) If after an investigation the office of inspector
general [commission] determines that a person violated Subsection
(a), the office [commission] shall:
(1) notify the person of the alleged violation not
later than the 30th day after the date the office [commission]
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 [commission] shall adopt rules as
necessary to implement this section.
SECTION 17. 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 [commission's] office of inspector
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 the state for any overpayments resulting from fraud,
waste or abuse in the Medicaid program, the child health plan
program, or another government funded program.
(15) 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
(16) 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 18. Section 533.012(c), Government Code, is amended
to read as follows:
(c) The [commission's] office of inspector general
[investigations and enforcement] shall review the information
submitted under this section as appropriate in the investigation of
fraud in the Medicaid managed care program.
SECTION 19. Section 21.014(b), Human Resources Code, is
amended to read as follows:
(b) The [person employed by the department as] inspector
general appointed under Subchapter R, Chapter 531, Government Code,
shall make reports to and consult with the agency director
[chairman of the board] regarding:
(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 20. 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 Subchapter R, Chapter 531,
Government Code.
SECTION 21. 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 [department] may impose a postpayment hold on payment of
future claims submitted by a provider if the office [department]
has prima facie evidence that the provider has committed fraud,
waste, abuse, or wilful misrepresentation regarding a claim for
reimbursement or cost report under the medical assistance program.
The office [department] must notify the provider of the postpayment
hold not 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 [department] shall file a request with the State Office of
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
[department] under Subsection (b). The office of inspector general
[department] shall discontinue the hold unless the office
[department] makes a prima facie showing at the hearing that the
evidence relied on by the office of inspector general [department]
in imposing the hold is relevant, credible, and material to the
issue of fraud, waste, abuse, or wilful misrepresentation.
(d) The inspector general [department] shall adopt rules
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 [department] in the
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
[department's] request until the informal resolution process is
completed.
SECTION 22. 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 [department] shall adopt reasonable
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 23. Sections 32.0321(a) through (d), Human
Resources Code, are amended to read as follows:
(a) The office of inspector general [department] by rule may
recommend to the department and the department by rule may require
that each provider of medical assistance in a provider type that has
demonstrated significant potential for fraud, waste, or abuse to
file with the department a surety bond in a reasonable amount. The
office and the department by rule shall each require a provider of
medical assistance to file with the department a surety bond in a
reasonable amount if the office [department] identifies a pattern
of suspected fraud, waste, 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, waste, or abuse.
(b) The bond under Subsection (a) must be payable to the
department to compensate the department for damages resulting from
or penalties or fines imposed in connection with an act of fraud,
waste, or abuse committed by the provider under the medical
assistance program.
(c) Subject to Subsection (d) or (e), the office of
inspector general and the department by rule may require each
provider of 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 department to compensate residents of the
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 and the department may
not 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 24. Section 32.0322(a), Human Resources Code, is
amended to read as follows:
(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.
SECTION 25. 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 [the] inspector
general, or the Office of Inspector General in the United States
Department of Health and Human Services.
SECTION 26. 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
[department's] office of inspector general established under
Subchapter R, Chapter 531, Government Code.
SECTION 27. 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 and inspectors general
commissioned by the Texas Youth Commission as officers under
Sections 61.0451 and 61.0931, Human Resources Code;
(30) officers appointed by the inspector general of
the Texas Department of Criminal Justice under Section 493.019,
Government Code;
(31) investigators commissioned by the Commission on
Law Enforcement Officer Standards and Education under Section
1701.160, Occupations Code;
(32) commission investigators commissioned by the
Texas Private Security Board under Section 1702.061(f),
Occupations Code;
(33) the fire marshal and any officers, inspectors, or
investigators commissioned by an emergency services district under
Chapter 775, Health and Safety Code;
(34) officers commissioned by the State Board of
Dental Examiners under Section 254.013, Occupations Code, subject
to the limitations imposed by that section; [and]
(35) investigators commissioned by the Texas Juvenile
Probation Commission as officers under Section 141.055, Human
Resources Code; and
(36) officers commissioned by the office of inspector
general established under Subchapter R, Chapter 531, Government
Code.
SECTION 28. Sections 531.102 and 531.1021, Government Code,
are repealed.
SECTION 29. Section 411.086, Government Code, is amended to
read as follows:
Sec. 411.083. DISSEMINATION OF CRIMINAL HISTORY RECORD
INFORMATION. (a) Criminal history record information maintained
by the department is confidential information for the use of the
department and, except as provided by this subchapter, may not be
disseminated by the department.
(b) The department shall grant access to criminal history
record information to:
(1) criminal justice agencies;
(2) noncriminal justice agencies authorized by
federal statute or executive order or by state statute to receive
criminal history record information;
(3) the person who is the subject of the criminal
history record information;
(4) a person working on a research or statistical
project that:
(A) is funded in whole or in part by state funds;
or
(B) meets the requirements of Part 22, Title 28,
Code of Federal Regulations, and is approved by the department;
(5) an individual or an agency that has a specific
agreement with a criminal justice agency to provide services
required for the administration of criminal justice under that
agreement, if the agreement:
(A) specifically authorizes access to
information;
(B) limits the use of information to the purposes
for which it is given;
(C) ensures the security and confidentiality of
the information; and
(D) provides for sanctions if a requirement
imposed under Paragraph (A), (B), or (C) is violated;
(6) an individual or an agency that has a specific
agreement with a noncriminal justice agency to provide services
related to the use of criminal history record information
disseminated under this subchapter, if the agreement:
(A) specifically authorizes access to
information;
(B) limits the use of information to the purposes
for which it is given;
(C) ensures the security and confidentiality of
the information; and
(D) provides for sanctions if a requirement
imposed under Paragraph (A), (B), or (C) is violated;
(7) a county or district clerk's office; [and]
(8) the Office of Court Administration of the Texas
Judicial System; and
(9) officers commissioned by the office of inspector
general established under Subchapter R, Chapter 531, Government
Code.
(c) The department may disseminate criminal history record
information under Subsection (b)(1) only for a criminal justice
purpose. The department may disseminate criminal history record
information under Subsection (b)(2) only for a purpose specified in
the statute or order. The department may disseminate criminal
history record information under Subsection (b)(4), (5), or (6)
only for a purpose approved by the department and only under rules
adopted by the department. The department may disseminate criminal
history record information under Subsection (b)(7) only to the
extent necessary for a county or district clerk to perform a duty
imposed by law to collect and report criminal court disposition
information. Criminal history record information disseminated to a
clerk under Subsection (b)(7) may be used by the clerk only to
ensure that information reported by the clerk to the department is
accurate and complete. The dissemination of information to a clerk
under Subsection (b)(7) does not affect the authority of the clerk
to disclose or use information submitted by the clerk to the
department. The department may disseminate criminal history record
information under Subsection (b)(8) only to the extent necessary
for the office of court administration to perform a duty imposed by
law to compile court statistics or prepare reports. The office of
court administration may disclose criminal history record
information obtained from the department under Subsection (b)(8) in
a statistic compiled by the office or a report prepared by the
office, but only in a manner that does not identify the person who
is the subject of the information.
(d) The department is not required to release or disclose
criminal history record information to any person that is not in
compliance with rules adopted by the department under this
subchapter or rules adopted by the Federal Bureau of Investigation
that relate to the dissemination or use of criminal history record
information.
SECTION 30. (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 31. (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
Subchapter R, Chapter 531, Government Code, as added by this Act,
until February 1, 2011, and may be reappointed under Subchapter R,
Chapter 531, if the person has the qualifications required under
that subchapter.
(b) Not later than February 1, 2011, the governor shall
appoint an inspector general for the Office of Inspector General
under Subchapter R, Chapter 531, Government Code, as added by this
Act, to a term expiring February 1, 2013.
SECTION 32. On the effective date of this Act:
(1) all functions, activities, employees, rules,
forms, money, property, contracts, memorandums of understanding,
records, and obligations of the office of inspector general under
Section 531.102(a-1), Government Code, become functions,
activities, employees, rules, forms, money, property, contracts,
memorandums of understanding, records, and obligations of the
Office of Inspector General established under Subchapter R, Chapter
531, Government Code, as added by this Act, without a change in
status; and
(2) all money appropriated or budgeted for the office
of inspector general under Section 531.102(a-1), Government Code,
including money for providing administrative support, is
considered appropriated for the use of the Office of Inspector
General established under Subchapter R, Chapter 531, Government
Code, as added by this Act.
SECTION 33. If before implementing any provision of this
Act a state office or agency determines that a waiver or
authorization from a federal agency is necessary for implementation
of that provision, the office or 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 34. 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, 2009.