HBA- NRS, CCH H.B. 2178 77(R)BILL ANALYSIS Office of House Bill AnalysisH.B. 2178 By: Salinas Public Health 7/16/2001 Enrolled BACKGROUND AND PURPOSE Medicaid reimbursement rates might provide unscrupulous chemical dependency providers with an incentive to over diagnose and over treat children for chemical dependency. From February 1997 through January 2001, the Health and Human Services Medicaid fraud division found that 1170 children in Texas less than 10 years of age were diagnosed as chemically dependent or chemically abusive and that 3779 children ages 10 through 13 received chemical dependency treatments. It is believed that some of these diagnoses are incorrect and fraudulent and that treatment for chemical dependency is unwarranted for some of these children. After chemical dependency services are rendered and a Medicaid claim is filed with the National Health Insurance Corporation (NHIC), the child's treatment history is entered into the NHIC database, which can then be accessed by private insurance companies when researching potential policyholders for pre-existing conditions. Consequently, children can be stigmatized and penalized throughout their lives for an incorrect or fraudulent diagnosis of chemical dependency or abuse. House Bill 2178 requires a diagnosis of chemical dependency to be expunged from a child's records following the final conviction of a chemical dependency treatment provider for submitting a fraudulent claim for Medicaid reimbursement. 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. ANALYSIS House Bill 2178 amends the Government Code to require the Health and Human Services Commission (HHSC) or other agency that operates a portion of the state Medicaid program, following the final conviction of a chemical dependency treatment provider for submitting a fraudulent claim for Medicaid reimbursement to expunge a diagnosis of chemical dependency in a child that has been entered in any appropriate official record of HHSC or an agency, applicable medical records in HHSC's or an agency's custody, and applicable records of a company that HHSC contracts with for the processing and payment of Medicaid claims. EFFECTIVE DATE September 1, 2001.