bill rewrites whose criminal history Medicaid checks can pull

The text as introduced · 526 words

89R8739 LRM-D

By: Hagenbuch
S.B. No. 1640

A BILL TO BE ENTITLED

AN ACT

relating to access to criminal history record information for

purposes of the Medicaid program.

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

SECTION 1. Section 411.1143, Government Code, as effective

April 1, 2025, is amended by amending Subsection (a-1) and adding

Subsection (e) to read as follows:

(a-1) Criminal history record information the Health and

Human Services Commission or the office of inspector general is

authorized to obtain under Subsection (a) includes criminal history

record information relating to:

(1) a person that:

(A) has a direct or indirect ownership interest,

or a combination of direct and indirect ownership interests, that

equals five percent or more in the provider or person applying to

enroll as a provider;

(B) owns an interest of five percent or more in a

mortgage, deed of trust, promissory note, or other obligation

secured by the provider or person applying to enroll as a provider

if that interest equals at least five percent of the value of the

property or other assets of the provider or person applying to

enroll as a provider;

(C) is an officer or director of the provider or

person applying to enroll as a provider if that provider or

applicant is organized as a corporation; or

(D) is a partner in the provider or person

applying to enroll as a provider if that provider or applicant is

organized as a partnership [ a person with a direct or indirect

ownership or control interest, as defined by 42 C.F.R. Section

455.101, in a provider of five percent or more ]; and

(2) a managing employee of the provider or person

applying to enroll as a provider [ a person whose information is

required to be disclosed in accordance with 42 C.F.R. Part 1001 ].

(e) In this section:

(1) "Managing employee," with respect to a provider or

person applying to enroll as a provider, means an individual,

including a general manager, business manager, administrator, or

director, who:

(A) exercises operational or managerial control

over all or part of the provider or applicant; or

(B) directly or indirectly conducts the daily

operations of all or part of the provider or applicant.

(2) "Medicaid agency" means the single state agency

administering or supervising the administration of the state

Medicaid plan.

(3) "Ownership interest," with respect to a provider

or person applying to enroll as a provider, means having equity in

the provider's or applicant's capital, stock, or profits.

(4) "Provider" means:

(A) an individual or entity that provides

Medicaid services under an agreement with the Medicaid agency; or

(B) an individual or entity that engages in the

delivery of health care services through the Medicaid managed care

program and that is authorized by this state to deliver those

services.

SECTION 2. This Act takes effect April 1, 2025, if this Act

receives a vote of two-thirds of all the members elected to each

house, as provided by Section 39, Article III, Texas Constitution.

If this Act does not receive the vote necessary for effect on that

date, this Act takes effect September 1, 2025.