HBA-GUM S.B. 1588 76(R) BILL ANALYSIS Office of House Bill AnalysisS.B. 1588 By: Zaffirini Public Health 4/27/1999 Engrossed BACKGROUND AND PURPOSE Texas expended $7.3 billion in 1997 on its Medicaid program. The 75th Texas Legislature directed the comptroller of public accounts to study the size and nature of fraud and overpayments in the Medicaid program and other state health care programs. S.B. 1588 requires a managed care organization (MCO) to cooperate with Heath and Human Services Commission (HHSC) investigations. This bill also requires an MCO to submit certain information to HHSC, and requires an MCO to cooperate with HHSC investigations. 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 Chapter 533A, Government Code, by adding Section 533.012, as follows: Sec. 533.012. INFORMATION FOR FRAUD CONTROL. Requires each managed care organization (MCO) contracting with the Health and Human Services Commission (HHSC) to submit certain specified documents to HHSC. Requires submitted information to be in a form prescribed by HHSC, and be updated as required by HHSC. Requires the HHSC office of investigations and enforcement to review submitted information for fraud in the Medicaid managed care program, as appropriate. Authorizes the comptroller of public accounts to review the information. SECTION 2. Amends Section 533.005, Government Code, to require a contract between an MCO and HHSC to contain a requirement that the MCO provide required information, and comply with HHSC investigations and enforcement. SECTION 3. Effective date: September 1, 1999. SECTION 4. Makes application of this Act prospective. SECTION 5. Emergency clause.