HBA-NMO H.B. 1514 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 1514
By: Maxey
Public Health
3/14/1999
Introduced



BACKGROUND AND PURPOSE 

Currently, the Texas Department of Health pays premiums in advance for both
its fee-for-service and managed care arrangements, incurring a cost for
Medicaid clients every month whether they receive health care services or
not.   The comptroller matched bureau of vital statistics death records for
1996 and 1997 with the November 1997 medical eligibility files of the Texas
Department of Human Services (DHS) and discovered that 3,395 Texans
eligible for fee-for-service Medicaid remained on DHS eligibility files for
30 or more days after their deaths.  Because the state pays Medicaid
fee-forservice premiums in advance, this represents a potential fiscal loss
to the state. H.B. 1514 implements certain procedures to ensure that the
deceased are removed from Medicaid eligibility lists.     

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 531.0214, Government Code, by adding Subsection
(e), as follows: 

(e) Requires the Health and Human Services Commission (commission) to
ensure that the database system is used each month to match bureau of vital
statistics death records with a list of persons eligible for medical
assistance under Chapter 32 (Medical Assistance Program), Human Resources
Code, and to ensure that each person that is deceased is promptly removed
from that list. 

SECTION 2.  Amends Section 531.106, Government Code, by adding Subsection
(g), as follows: 

(g) Provides that the learning or neural network technology implemented
under this section, each month, must match bureau of vital statistics death
records with Medicaid claims filed by a provider.  Requires the commission,
if it determines that a provider has filed a claim for services provided to
a person after the person's date of death, to refer the case for
investigation to the commission's office of investigations and enforcement. 

SECTION 3.  Requires the commission to implement the matching systems
required by Sections 531.0214(e) and 531.106(g), Government Code, not later
than January 1, 2000. 

SECTION 4.  Effective date: September 1, 1999.

SECTION 5.  Emergency clause.