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6 Document(s) [ Subject: Medicaid fraud ]

Committee: Senate Health and Human Services
Title: Interim Report
Subjects: Assisted living facilities | At-risk youth | Cancer | Cancer Prevention and Research Institute of Texas | Child welfare | Children without placement | Children's mental health | Coronavirus | Emergency management | Employee Retirement Income Security Act of 1974 | Family and Protective Services, Texas Department of | Foster care | Health and Human Services Commission, Texas | Health care | Health insurance | Hurricane Beryl | Intermediate Care Facilities for Persons with Mental Disabilities | Juvenile detention facilities | Long-term care | Medicaid | Medicaid fraud | Medical licensing | Medical screening | Mental health services | Nursing education | Nursing homes | Nursing shortages | Occupational licenses | Patient Protection and Affordable Care Act | Physician shortages | Power outages | Thriving Texas Families | Vaccine mandates | Workforce Commission, Texas |
Library Call Number: L1836.88 H349
Session: 88th R.S. (2023)
Online version: View report [94 pages  File size: 3,997 kb]
Charges: This report should address the charges below.
1. Children’s Mental Health: Review care and services currently available to the growing population of Texas children with high acuity mental and behavioral health needs. Make recommendations to improve access to care and services for these children that will support family preservation and prevent them from entering the child welfare system.
2. Access to Health Care: Evaluate current access to primary and mental health care. Examine whether regulatory and licensing flexibilities could improve access to care, particularly in medically underserved areas of Texas. Make recommendations, if any, to improve access to care while maintaining patient safety.
3. Health Insurance: Examine the Texas health insurance market and alternatives to employer-based insurance. Identify barriers Texans face when navigating a complex health insurance market. Make recommendations that help individuals obtain health care coverage.
4. Cancer Prevention: Identify and recommend ways to address the growing impact of cancer on Texans by evaluating state investments in cancer prevention and screenings including, but not limited to, "CT," "MRI," and "PET" scans. Study and make recommendations on funding adequacy for prevention efforts at the Cancer Prevention and Research Institute of Texas (CPRIT).
5. Monitoring: Monitor the implementation of legislation addressed by the Senate Committee on Health and Human Services passed by the 88th Legislature, as well as relevant agencies and programs under the committee's jurisdiction. Specifically, make recommendations for any legislation needed to improve, enhance, or complete implementation of the following:
  • SB 7, 88th 3rd C.S., relating to prohibiting a private employer from adopting or enforcing certain COVID-19 vaccine mandates; authorizing an administrative penalty;
  • SB 24, 88th R.S., relating to the powers and duties of the Health and Human Services Commission and the transfer to the commission of certain powers and duties from the Department of Family and Protective Services;
  • SB 25, 88th R.S., relating to support for nursing-related postsecondary education, including scholarships to nursing students, loan repayment assistance to nurses and nursing faculty, and grants to nursing education programs;
  • SB 26, 88th R.S., relating to local mental health authority and local behavioral health authority audits and mental and behavioral health reporting, services, and programs;
  • SB 1849, 88th R.S., relating to an interagency reportable conduct search engine, standards for a person's removal from the employee misconduct registry and eligibility for certification as certain Texas Juvenile Justice Department officers and employees, and the use of certain information by certain state agencies to conduct background checks;
  • Initiatives to reduce Medicaid fraud, waste, and abuse, as well as other cost containment strategies; and
  • Medicaid managed care oversight and accountability.
6. Protecting Vulnerable Texans in Emergencies: Examine commercial residential settings for the elderly and individuals with intellectual disabilities, including assisted living facilities, boarding homes, group homes, and independent living communities. Identify emergency preparedness and response protocols required during severe weather for these populations. Make recommendations, if necessary, for the establishment and enforcement of emergency protocols to ensure vulnerable populations are protected.
Committee: Senate Health and Human Services
Title: Interim Report
Subjects: Cancer Prevention and Research Institute of Texas | Child abuse | Child Protective Services | Computers and government | Contraceptives | Dental Examiners, Texas State Board of | Family planning | Foster care | Healthy Texas Women | Homelessness | Medicaid | Medicaid fraud | Medically uninsured | Mental health services | Mentally ill persons | Office of Inspector General, Health and Human Services Commission, Texas | Patient Protection and Affordable Care Act | Substance abuse | Temporary Assistance for Needy Families | Welfare eligibility | Welfare reform | Welfare-to-work | Women's health |
Library Call Number: L1836.83 H349
Session: 83rd R.S. (2013)
Online version: View report [58 pages]
Charges: This report should address the charges below.
1. Review the Department of Family and Protective Services’ efforts to reduce child fatalities. Review the process by which the Department of Family and Protective Services collects and uses data to evaluate agency performance and improve outcomes for children in the Child Protective Services system. Make recommendations to ensure the process effectively uses data to strategically improve caseworker performance, and identify and improve upon deficiencies within the system and improve overall outcomes for children and reduce child fatalities.
2. Monitor the implementation of programs that were created or expanded by the 83rd Legislature to improve mental health and substance abuse services and assess these efforts' contribution to improved outcomes such as reduced recidivism in state hospitals, diversion from emergency rooms and county jails, and access to permanent supportive housing. Identify and address gaps in the current mental health and substance abuse system and make recommendations to better coordinate services across agencies and programs.
3. Build on previous legislative achievements in women's healthcare by examining women’s access to preventative health care, pregnancy services, and post-partum care, and exploring ways to expand access and improve quality, particularly in rural and underserved areas of the state. Monitor the implementation of women's health programs in Texas. Assess these programs' impact on outcomes such as improving access to preventative services, reducing unplanned pregnancies, and achieving cost savings. Recommend ways to better coordinate the various programs in a manner that increases the number of women served, ensures adequate provider capacity statewide, and maximizes efficiencies to the state.
4. Identify cost-effective alternatives to Medicaid and the Affordable Care Act to better connect low income individuals to health care services through private market-based solutions, including Medicaid block grants and waivers. Recommendations should strive to encourage cost sharing, promote personal responsibility, reduce uncompensated care costs, contain increasing health care costs, improve access to care, address access to emergency department care issues in rural areas, promote the use of existing private coverage or employee sponsored coverage, reduce non-­?emergency use of emergency departments, and reduce the need for federal approval to the state Medicaid plan.
5. Evaluate the Temporary Assistance for Needy Families (TANF) program structure. Make recommendations to improve the program's operations and ensure the program achieves outcomes that allow TANF recipients to find employment and achieve self-sufficiency. Recommendations should seek to ensure Texas is using the most effective work-related requirements and drug testing protocols.
6. Evaluate the current state of prescription drug abuse and strategies for reducing prescription drug abuse in Texas. Make recommendations on how these policies can be improved or modified to enhance the State of Texas’ handling of services, treatments and education related to prescription drug abuse and to reduce the overall prevalence of prescription drug abuse.
7. Monitor the implementation of legislation addressed by the Senate Committee on Health and Human Services, 83rd Legislature, Regular Session, and make recommendations for any legislation needed to improve, enhance, and/or complete implementation, including but not limited to:
  • Monitor implementation of initiatives aimed at improving the quality and efficiency of Medicaid long-term care services and supports, including the redesign of services for individuals with intellectual and developmental disabilities.
  • Monitor implementation of initiatives aimed at reducing fraud, waste, and abuse in Texas Medicaid and other health and human services programs.
  • Dental Board Reforms: Monitor implementation of initiatives aimed at improving the State Board of Dental Examiners' ability to protect public safety, including strengthening the Board's authority and enforcement powers, improving the complaint review and resolution processes, and increasing staffing to improve the Board's ability to respond to complaints and potential fraudulent activity. Determine whether there are additional changes necessary to ensure that the Board is able to regulate the practice of dentistry and ensure public safety.
  • Cancer Prevention and Research Institute: Monitor implementation of initiatives aimed at restructuring the governance structure, eliminating conflicts of interest, and increasing transparency at the Cancer Prevention and Research Institute of Texas (CPRIT).
Committee: Senate Finance
Title: Interim Report
Library Catalog Title: Interim charge recommendations to the 80th Legislature
Subjects: Banks and banking | Driver Responsibility Program | Emergency medical services | Federal funds | Health care costs | Indigent health care | Medicaid | Medicaid fraud | Money transfers | Transportation planning | Transportation, Texas Department of | Trauma Facilty/EMS account |
Library Call Number: L1836.79 F49
Session: 79th R.S. (2005)
Online version: View report [62 pages  File size: 16,186 kb]
Charges: This report should address the charges below.
1. Review health care funding, focusing on the Medicaid program, Medicare Part D, hospital reimbursements and trauma and indigent care.
2. Study the method through which fees are collected under the Driver's Responsibility Program in order in maximize the amount of money for trauma funding and transportation. Look specifically at collection rates and develop means to enhance them.
3. Determine the number of commercial and consumer transactions, including wire transfers, that occur in Texas. Determine the amount of monies that are sent internationally from Texas. Study the feasibility of creating a pilot program in Harris County that captures a percentage of revenues from such transactions, and request an Opinion from the Attorney General's Office to pursue these revenues as a potential source for health care funding.
4. Review the process by which the Texas Department of Transportation Commission allocates funds to the districts through the Allocation Program. Include a description of all scoring mechanisms used in making allocations of resources and make recommendations for maximizing the use of these funds to meet Legislative objectives. Joint Charges with Senate Transportation & Homeland Security Committee.
5. Review the process by which the Texas Department of Transportation Commission determines which federal funding sources should be implemented to comply with funding reductions mandated by Congress. Assess the Commission's options for determining how projects that were to be funded out of these reduced revenue sources will be funded this biennium. Joint Charges with Senate Transportation & Homeland Security Committee.
Committee: Senate Health and Human Services
Title: Interim Report
Library Catalog Title: Interim report to the 79th Legislature
Subjects: Adult Protective Services | Call centers | Child Protective Services | Children's Health Insurance Program | Databases | Family and Protective Services, Texas Department of | Health care | Hospitals | Immunizations | Indigent health care | Long-term care | Medicaid | Medicaid fraud | Medical Board, Texas | Medicare | Prompt payment of insurance claims | Social service agencies | State government reorganization | Welfare |
Library Call Number: L1936.78 H349
Session: 78th R.S. (2003)
Online version: View report [247 pages  File size: 1,485 kb]
Charges: This report should address the charges below.
1. Study and make recommendations on structural reform, efficiency improvements, and cost savings in the state Medicaid and CHIP programs, with a goal of changing the method and delivery of service to reduce costs while providing the intended services. The Committee should examine and make recommendations to: lower institutional costs; subsidize private insurance in lieu of Medicaid and CHIP where possible; use consumer-directed care models; reimburse health care providers based upon outcomes where feasible; match currently unmatched local funds with federal funds; alter Texas' current method of finance and distribution of DSH; develop possible HIFA waiver options that incorporate premium subsidization; develop accountability and incentive measures for outcomes within Medicaid managed care and CHIP; seek flexibility from federal government to allow options and waivers and enhance federal funds; examine local models for delivery of Medicaid while maintaining best practices; and expand access to mental health services through expansion of behavioral health organization model. The Committee will coordinate these studies with the Health and Human Services Transition Legislative Oversight Committee review of mental health and mental retardation services.
2. Monitor implementation and make recommendations to improve HB 2292, 78th R.S.. Include reviews of implementation of the preferred drug list and prior authorization and the new call center for determination of program and service eligibility. The Committee will coordinate activities with the Health and Human Services Transition Legislative Oversight Committee.
3. Study and make recommendations on improving Texas's county and local indigent health care system. Consider whether the system should be regionalized to reflect usage and gain efficiencies, so that one or more counties are not paying for regional health care.
4. Monitor the implementation and make recommendations to enhance the effectiveness of legislation relating to the Board of Medical Examiners, legislation relating to childhood immunizations, legislation relating to the pilot front end Medicaid fraud reduction systems, federal developments related to TANF reauthorization and related programs, expansion and new construction of Federally Qualified Health Centers, federal developments related to prescription drugs in Medicare and the effect on Medicaid. Also, monitor and report on the use of new federal Medicare funds allocated for Texas
5. Study and make recommendations on increasing electronic transactions in health care. Review the use and make recommendations on improving technology in health care administration, including expediting pre-authorizations and increasing the efficiency of claims processing so that medical providers are paid once procedures are pre-authorized and performed, and administrative costs lowered, benefitting both the consumer and the managed health care organizations.
6. Study health facility regulation in Texas and make recommendations that facilitate innovation and patient safety. Concentrate studies on hospitals, including niche hospitals, Federally Qualified Health Centers and long term care facilities, and make recommendations for improving patient choice, facility competition, indigent health care, and for maintaining a competitive, patient-oriented health care industry.
7. Study and make recommendations on improving the Protective and Regulatory Services service levels payment system and tiered adoption subsidy program. Study and make recommendations on improving the recruitment and retention of foster care families.
Committee: House General Investigating
Title: Interim Report
Library Catalog Title: House Committee on General Investigating, Texas House of Representatives interim report, 2000 : a report to the House of Representatives, 77th Texas Legislature.
Subjects: Dentists | Education, Texas State Board of | General Services Commission, Texas | Homeland security | Investment managers | Medicaid | Medicaid fraud | Permanent School Fund | Persons with disabilities | Public Safety, Texas Department of | Risk Management, State Office of | State buildings | State employees | State government contracts | State Preservation Board | Stock investments | Texas Council on Purchasing from People with Disabilities | Texas Health Steps Program | Texas State Capitol |
Library Call Number: L1836.76 g286
Session: 76th R.S. (1999)
Online version: View report [85 pages  File size: 495 kb]
Charges: This report should address the charges below.
1. Investigate allegations of excessive use of crowns and other aggressive dental procedures by certain providers in the Medicaid program.
2. Investigate recent actions of the State Board of Education relating to its management of the Permanent School Fund.
3. Review the security resources available to protect state employees and state buildings.
4. Review the program and processes by which disabled workers are afforded priority in certain state procurements, including the roles of the General Services Commission, the Council for Purchasing from People with Disabilities, and the Texas Industries for the Blind and Handicapped.
Committee: Senate Health and Human Services, Interim
Title: Interim report
Library Catalog Title: Texas Senate Interim Committee on Health and Human Services interim report.
Subjects: Immigration | Medicaid fraud | Medical billing | Prompt payment of insurance claims | Rural issues | Rural population | Senior citizens | Tobacco advertising | Tobacco laws and regulations | Tobacco lawsuit | Tobacco settlement receipts | Underage smoking | Welfare | Welfare fraud | Welfare reform |
Library Call Number: L1836.75 h349
Session: 75th R.S. (1997)
Online version: View report [160 pages  File size: 7,598 kb]
Charges: This report should address the charges below.
1. Monitor the implementation of SB 30, 75th R.S., passed by the Legislature during the 1997 regular session, regarding fraud and improper payments under state Medicaid and welfare programs. If needed, make recommendations for further legislative and regulatory action.
2. Develop a plan for oversight of efforts by state health and human services agencies, the Attorney General, and law enforcement agencies, to detect and reduce fraud and improper payments under state Medicaid and welfare programs. The plan should address enforcement and punishment under state and federal civil and criminal laws.
3. Continue to monitor federal welfare reform, and make recommendations for necessary legislative or regulatory action.
4. Study the implementation of SB 55, 75th R.S., passed by the Legislature during the 1997 regular session, regarding minors' access to tobacco.
5. Monitor developments in the federal tobacco settlement discussions and identify potential, fiscal impacts to Texas governments.
6. Examine the demographic trends of the state that will impact the health and human services delivery system in the future, including immigration, rural concerns, and the aging state population. Make recommendations for research and legislative action, if necessary.
7. Study current practices in patient billing by Texas hospitals and providers of health care to evaluate the accuracy, clarity and timliness of patient billing. The Committee should examine existing regulatory authority and determine whether there is suficient authority to address problems in patient billings. If necessary, the Committee may make recommendations for standardizing patient billing; ensuring that bills are accurate and complete yet simple enough for patients to understand; providing a meaningful appeals process for incorrect or excessive billings; and establishing guidelines for submission of bill for payment within a reasonable time period.

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