Texas 2025 - 89th Regular

Texas Senate Bill SB961

Filed
1/29/25  
Out of Senate Committee
3/24/25  
Voted on by House
 
Governor Action
 
Bill Becomes Law
 

Caption

Relating to fraud prevention and verifying eligibility for benefits under Medicaid.

Impact

If enacted, SB961 is poised to significantly alter the administration of Medicaid in Texas by instituting stricter verification processes. The requirement for data matching with various public records aims to ensure that benefits are accurately allocated only to those who are eligible. Additionally, it establishes that self-attestation will not suffice without further verification, thereby increasing the accountability of both recipients and service providers. This could potentially result in more rigorous scrutiny of applications and ongoing eligibility assessments.

Summary

Senate Bill 961 is aimed at enhancing fraud prevention and verifying eligibility for benefits under the Medicaid program in Texas. This legislation mandates periodic electronic data matches to ensure the accuracy of income eligibility claims made by Medicaid recipients. It also introduces requirements for verifying self-attested criteria related to income, residency, citizenship, and other factors, thereby tightening the criteria for Medicaid enrollment. The bill reflects a growing concern over the integrity of benefit programs and seeks to eliminate opportunities for fraudulent claims, thus protecting state resources.

Sentiment

Discussion surrounding SB961 has been largely supportive among lawmakers advocating for fiscal responsibility and the integrity of the Medicaid system. Proponents argue that these measures will deter fraud and misuse of resources intended for low-income individuals and families. However, there are concerns among some stakeholders about the potential for increased bureaucratic hurdles that may negatively affect vulnerable populations by making it harder for them to access essential health services.

Contention

The notable points of contention in SB961 revolve around the balance between fraud prevention and equitable access to healthcare benefits. Critics of the bill express concerns that the stringent verification mandates could disproportionately impact low-income individuals who already face challenges in navigating the complexities of health care systems. By potentially complicating the enrollment and verification processes, there is a risk that eligible recipients may be unjustly denied benefits, which raises questions about the philosophies underpinning Medicaid's accessibility.

Texas Constitutional Statutes Affected

Human Resources Code

  • Chapter 32. Medical Assistance Program
    • Section: New Section
    • Section: New Section
    • Section: New Section
    • Section: New Section
  • Chapter 36. Health Care Program Fraud Prevention
    • Section: New Section
    • Section: New Section

Government Code

  • Chapter 544. Fraud, Waste, Abuse, And Overcharges Relating To Health And Human Services
    • Section: 0455
    • Section: 0456
    • Section: 0455
    • Section: 0456

Election Code

  • Chapter 16. Cancellation Of Registration
    • Section: New Section

Companion Bills

No companion bills found.

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