TX
Texas House Bill HB2307

Texas 2023 - 88th Regular

Texas House Bill HB2307

Voted on by House
 
Out of Senate Committee
 
Voted on by Senate
 
Governor Action
 
Bill Becomes Law
 

Caption

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.

Impact

The introduction of HB 2307 specifically affects how recoveries from fraud investigations are managed financially. As it stands, there have been concerns that the current system seems to favor MCOs, potentially at the expense of taxpayers. By instituting a 50-50 split in recoveries, the bill aims to create a more equitable framework that not only bolsters state finances but also incentivizes MCOs to actively engage in identifying and reporting fraud. This change could significantly impact the overall financial management of Medicaid programs.

Summary

House Bill 2307 seeks to clarify the treatment of recoveries resulting from fraud and abuse investigations under Medicaid and the child health plan program. The bill proposes that when a managed care organization (MCO) recovers funds due to these investigations, the recovered amount should be split equally between the MCO and the state. This amendment is intended to address and standardize the financial implications of such recoveries, ensuring that both parties benefit equitably from actions taken against Medicaid fraud.

Sentiment

The sentiment surrounding HB 2307 appears to be mixed, with varying perspectives from stakeholders. Proponents of the bill, including some legislators and possibly the Office of the Inspector General, argue that it is a necessary update to clarify existing practices and ensure fairness in the recovery process. However, there are also voices of dissent, notably from individuals representing vulnerable populations who feel that the implications of the bill could inadvertently affect the allocation of resources available for Medicaid recipients, necessitating careful consideration.

Contention

Notable points of contention regarding HB 2307 revolve around the ramifications of the proposed recovery split. Critics may express concerns that allocating half of the recovered funds to MCOs might detract from resources that should ideally remain within Medicaid to support vulnerable populations. Additionally, there are apprehensions about ensuring that the practice of splitting recoveries does not lead to diluted accountability for fraud, thereby necessitating rigorous oversight to protect taxpayer interests.

Texas Constitutional Statutes Affected

Government Code

  • Chapter 531. Health And Human Services Commission
    • Section: 1131

Companion Bills

TX SB935

Identical 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.

Previously Filed As

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 HB5018

Relating to certain payment recovery efforts by managed care organizations under Medicaid or the child health plan program.

TX HB2969

Relating to fraud, waste, and abuse in Medicaid and other health and human services programs.

TX SB2548

Relating to awarding contracts to managed care organizations under Medicaid and the child health plan program.

TX SB1150

Relating to assignment or transfer of certain contracts with managed care organizations under Medicaid and the child health plan program.

TX HB1720

Relating to certain facilities and care providers, including providers under the state Medicaid program and to improving health care provider accountability and efficiency under the child health plan and Medicaid programs; providing penalties.

TX H0815

Patient Referrals by Medicaid Managed Care Organizations and Managed Care Plans

TX HSB177

A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(See HF 525, HF 685.)

TX SSB1167

A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(See SF 462, SF 567.)

TX SB1803

Relating to investigations of and payment holds relating to allegations of fraud or abuse and investigations of and hearings on overpayments and other amounts owed by providers in connection with the Medicaid program or other health and human services programs.

Similar Bills

No similar bills found.