Bill Analysis
This legislation would implement some of the recommendations that were provided by the Sunset Advisory Committee in regards to the Office of the Inspector General (IG) within the Health and Human Services Commission.
This bill would do the following:
- Amend the definition of fraud, striking out the inclusion of unintentional technical, clerical, or administrative errors.
- Change how the Inspector General is appointed, by allowing the Executive Commissioner of Health and Human Services Commission to appoint the IG, instead of the governor.
- Adjust the timeline for which investigations must be completed by removing the 90 day preliminary investigation period and now requires completion within 45 days of a receiving a complaint.
- Require that full investigations be completed within 180 days of the complaint being filed. If additional time is needed, the IG is required to provide the subject of the investigation notice that the investigation will go beyond 180 days.
- Address that payment hold authority is a tool for enforcement that is to be used to mitigate any perpetual risk to the state.
- Appeal process for payment holds is clarified, and provides exceptions to entire payment holds if it jeopardizes an ongoing investigation by law enforcement, written evidence to remove the hold is provided, or the Attorney General certifies that a complaint should no longer be under investigation.
- Grant the IG the authority to share confidential drafts of audits or investigations that concern the
death of a child with the Department of Family and Protective Services, without jeopardizing the
confidentiality of those draft reports.
- Require an internal review of the investigative process by staff not directly involved with investigations.
- Require IG to investigate fraud waste and abused by managed care organizations.
- Require the Sunset Advisory Commission to conduct a special-purpose review of
OIG as part of its review of agencies for the 87th Legislature.
Vote Recommendation Notes
This legislation would clarify the role of the Inspector General within the Health and Human Services Commission and provide strict expectations for investigative procedures, including timelines for the completion of each stage of an investigation. Additionally, this legislation would clarify the justifications for payment holds and the process and criteria for which an entity can appeal these holds. Lastly, this legislation would require a special-purpose review of the procedures of the HHS Inspector General by means of a Sunset Review to be prepared for the 87th Legislative Session.
We support this legislation as it encourages the personal responsibility of the Health and Human Services Commission, by making adjustments that were recommended by a previous Sunset Review. It also works to continue reforming the responsibilities of the Inspector General by instructing another review to be completed by the 87th Legislative Session. We find the implementation of strict investigation timelines to promote efficiency which supports the principles of limited government.
