Bill Caption

Relating to the proof required to impose payment hold in certain cases of alleged fraud by Medicaid providers. 

Fiscal Notes

From the LBB: No significant fiscal implication to the state is anticipated. 

Bill Analysis

Under current law, it is up to the discretion of the commission to decide what constitutes as a significant financial risk to the state with regards to alleged Medicaid fraud. This bill mandates that the executive commissioner make and adopt rules regarding what constitutes an ongoing significant financial risk to the state and a threat to the integrity of Medicaid. It would also statutorily state that a payment may be held in cases of suspected fraud if the ongoing risk would result in a loss of $100,000 or more to the state.

Vote Recommendation Notes

This is a procedural change that does not appear to have a connection to our liberty principles, therefore we remain neutral.