| 1 | 1 | | 83R2760 EES-D |
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| 2 | 2 | | By: Guerra, Sheffield of Coryell, Munoz, Jr., H.B. No. 1536 |
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| 3 | 3 | | Cortez, Bell, et al. |
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| 4 | 4 | | |
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| 5 | 5 | | |
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| 6 | 6 | | A BILL TO BE ENTITLED |
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| 7 | 7 | | AN ACT |
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| 8 | 8 | | relating to a Medicaid provider's right to an administrative |
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| 9 | 9 | | hearing on an action taken by the office of inspector general for |
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| 10 | 10 | | the Health and Human Services Commission to recover overpayments |
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| 11 | 11 | | under the Medicaid program. |
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| 12 | 12 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 13 | 13 | | SECTION 1. Subchapter C, Chapter 531, Government Code, is |
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| 14 | 14 | | amended by adding Section 531.118 to read as follows: |
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| 15 | 15 | | Sec. 531.118. HEARINGS ON ACTIONS TAKEN BY OFFICE OF |
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| 16 | 16 | | INSPECTOR GENERAL TO RECOVER CERTAIN OVERPAYMENTS UNDER MEDICAID |
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| 17 | 17 | | PROGRAM. (a) A Medicaid provider from whom the commission's office |
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| 18 | 18 | | of inspector general seeks to recover an overpayment made to the |
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| 19 | 19 | | provider under the Medicaid program is entitled to a hearing on a |
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| 20 | 20 | | determination made or other action taken by the office to recover |
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| 21 | 21 | | the overpayment. A hearing under this section is a contested case |
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| 22 | 22 | | hearing under Chapter 2001. |
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| 23 | 23 | | (b) The State Office of Administrative Hearings shall |
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| 24 | 24 | | conduct a hearing under this section. After the hearing, the |
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| 25 | 25 | | office, subject to Subsection (c), shall make a final determination |
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| 26 | 26 | | on the matter. |
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| 27 | 27 | | (c) A provider may appeal an order by the State Office of |
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| 28 | 28 | | Administrative Hearings to repay an amount greater than $50,000 by |
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| 29 | 29 | | filing a petition for judicial review in a district court of Travis |
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| 30 | 30 | | County. An appeal under this section is by trial de novo. |
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| 31 | 31 | | SECTION 2. Section 531.118, Government Code, as added by |
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| 32 | 32 | | this Act, applies to a determination made or other action taken on |
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| 33 | 33 | | or after the effective date of this Act by the office of the |
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| 34 | 34 | | inspector general for the Health and Human Services Commission to |
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| 35 | 35 | | recover an overpayment made to a Medicaid provider. A |
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| 36 | 36 | | determination made or other action taken before the effective date |
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| 37 | 37 | | of this Act is governed by the law in effect when the determination |
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| 38 | 38 | | was made or action was taken, and the former law is continued in |
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| 39 | 39 | | effect for that purpose. |
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| 40 | 40 | | SECTION 3. If before implementing any provision of this Act |
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| 41 | 41 | | a state agency determines that a waiver or authorization from a |
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| 42 | 42 | | federal agency is necessary for implementation of that provision, |
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| 43 | 43 | | the agency affected by the provision shall request the waiver or |
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| 44 | 44 | | authorization and may delay implementing that provision until the |
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| 45 | 45 | | waiver or authorization is granted. |
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| 46 | 46 | | SECTION 4. This Act takes effect September 1, 2013. |
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