TX
Texas House Bill HB3481

Texas 2019 - 86th Regular

Texas House Bill HB3481

Caption

Relating to investigation of fraud, waste, and abuse in Medicaid managed care by the Health and Human Services Commission's office of inspector general.

Impact

The legislative impact of HB3481 is significant as it introduces clearer processes for investigating claims of fraud and abuse in Medicaid managed care organizations. This bill modifies existing laws to empower the inspector general's office to assess the practices of both Medicaid recipients and providers, specifically those organizations that display concerning rates of service denial based on medical necessity. Consequently, it could lead to improved service delivery and ensure that Medicaid resources are utilized efficiently and effectively.

Summary

House Bill 3481 focuses on enhancing the investigation of fraud, waste, and abuse within the Medicaid managed care system in Texas. The bill mandates the Health and Human Services Commission's office of inspector general to develop a process for healthcare facilities and providers to report such misconduct. By formalizing this reporting mechanism, the bill aims to improve oversight and accountability across the Medicaid system, addressing systemic issues that have persisted over time due to insufficient oversight.

Contention

Debates surrounding HB3481 may arise from concerns about the adequacy of oversight versus the potential for overreach into healthcare management practices. Proponents of the bill argue that it is essential to safeguard taxpayer dollars and ensure that vulnerable populations receive appropriate care. However, there may be apprehensions among healthcare providers regarding the administrative burden of additional reporting and scrutiny. Therefore, balancing accountability with operational efficiency will be crucial as the bill progresses through the legislative process.

Companion Bills

No companion bills found.

Previously Filed As

TX SB1698

Relating to peace officers commissioned by the Health and Human Services Commission's office of inspector general.

TX HB3888

Relating to peace officers commissioned by the Health and Human Services Commission's office of inspector general.

TX HB4611

Relating to the nonsubstantive revision of the health and human services laws governing the Health and Human Services Commission, Medicaid, and other social services.

TX HB2375

Relating to the transfer of authority regarding the review and resolution of complaints against the Department of Family and Protective Services to the Health and Human Services Commission's office of inspector general.

TX HB2307

Relating to the retention by a managed care organization of certain money recovered as a result of a fraud or abuse investigation under Medicaid or the child health plan program.

TX SB935

Relating to the retention by a managed care organization of certain money recovered as a result of a fraud or abuse investigation under Medicaid or the child health plan program.

TX SB2103

Relating to transferring certain investigations of abuse, neglect, and exploitation to the Health and Human Services Commission.

TX HB1283

Relating to prescription drug formularies applicable to the Medicaid managed care program.

TX SB1113

Relating to prescription drug formularies applicable to the Medicaid managed care program.

TX HB1293

Relating to the reimbursement of prescription drugs under Medicaid and the child health plan program.

Similar Bills

UT SB0257

Medicaid Accounts Amendments

UT HB0247

Child Health Care Coverage Amendments

AR SB518

To Amend The Medicaid Fraud Act And The Medicaid Fraud False Claims Act; And To Update Language And Definitions To Reflect Changes Within The Healthcare System;.

AR SB515

To Amend The Medicaid Fraud Act And The Medicaid Fraud False Claims Act.

UT HB0463

Medicaid Funding Amendments

NJ A3334

Requires Medicaid reimbursement for covered behavioral health services provided by local education agency to student who is eligible Medicaid beneficiary.

NJ S2416

Requires Medicaid reimbursement for covered behavioral health services provided by local education agency to student who is eligible Medicaid beneficiary.

NJ S3495

Provides for presumptive eligibility for home and community-based services and services provided through program of all-inclusive care for the elderly under Medicaid.