Medicaid inspector general gets easier hiring and background checks

The text as introduced · 677 words

89R5566 LRM-F

By: Noble
H.B. No. 142

A BILL TO BE ENTITLED

AN ACT

relating to the administration, authority, and duties of the Health

and Human Services Commission's office of inspector general.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 544.0106, Government Code, as effective

April 1, 2025, is amended to read as follows:

Sec. 544.0106. PROCUREMENT OF CONTRACT FOR REVIEW OF

INVESTIGATIVE FINDINGS BY QUALIFIED EXPERT. Notwithstanding any

other law, Subtitle D, Title 10, does not apply to the commission's

procuring of a contract for the services of a qualified expert to

review investigative findings under Section 544.0104 or 544.0105 to

the same extent that subtitle does not apply to the obtaining of an

expert witness under Section 2151.005. [ (a) If the commission does

not receive any responsive bids under Chapter 2155 on a competitive

solicitation for the services of a qualified expert to review

investigative findings under Section 544.0104 or 544.0105 and the

number of contracts to be awarded under this subsection is not

otherwise limited, the commission may negotiate with and award a

contract for the services to a qualified expert on the basis of:

[ (1) the contractor's agreement to a set fee, either as

a range or lump-sum amount; and

[ (2) the contractor's affirmation and the office of

inspector general's verification that the contractor possesses the

necessary occupational licenses and experience.

[ (b) Notwithstanding Sections 2155.083 and 2261.051, a

contract awarded under Subsection (a) is not subject to competitive

advertising and proposal evaluation requirements. ]

SECTION 2. Subchapter C, Chapter 544, Government Code, as

effective April 1, 2025, is amended by adding Section 544.0115 to

read as follows:

Sec. 544.0115. PERMITTED DISCLOSURE OF CERTAIN

INFORMATION. For purposes of performing the duties of the office of

inspector general under this subchapter, the office may disclose

information obtained in the course of conducting the office's

administrative oversight activities to:

(1) a federal, state, or local governmental entity,

including:

(A) a federal agency or an agency of this state or

another state;

(B) the criminal, civil, or administrative

department, division, bureau, or other entity with enforcement or

prosecutorial authority of:

(i) this state;

(ii) the United States;

(iii) another state; or

(iv) a local governmental entity of this

state or another state; and

(C) a political subdivision of this state; or

(2) a person authorized by the office to receive the

information.

SECTION 3. Section 544.0153(b), Government Code, as

effective April 1, 2025, is amended to read as follows:

(b) Except as required by federal law, to [ To ] determine a

health care professional's eligibility to participate as a Medicaid

provider, the office of inspector general may not conduct a

fingerprint-based criminal history record information check of a

health care professional who the office has confirmed under

Subsection (a) is licensed and in good standing. This subsection

does not prohibit the office from conducting a criminal history

record information check of a provider that is required or

appropriate for other reasons, including for conducting an

investigation of fraud, waste, or abuse.

SECTION 4. Section 544.0202(b), Government Code, as

effective April 1, 2025, is amended to read as follows:

(b) The commission shall:

(1) aggressively publicize successful fraud

prosecutions and fraud-prevention programs through all available

means, including the use of statewide press releases; and

(2) ensure that the commission or a health and human

services agency maintains and promotes an appropriate

communications system [ a toll-free telephone hotline ] for

reporting suspected fraud in programs the commission or a health

and human services agency administers.

SECTION 5. The following provisions of the Government Code

are repealed:

(1) Section 544.0201; and

(2) Section 544.0252(a).

SECTION 6. If before implementing any provision of this Act

a state agency determines that a waiver or authorization from a

federal agency is necessary for implementation of that provision,

the 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 7. This Act takes effect September 1, 2025.