Highlights of the 79th Texas Legislature - Senate

HEALTH AND HUMAN SERVICES/MEDICAID
necessary for a person to live in the most integrated setting appropriate to the needs of the person, and does not
affect compliance with the federal cost-effectiveness and efficiency requirements of the medical assistance waiver
program under 42 U.S.C. Sections 1396n(b) and 1396n(c)(2)(D).
Authorizes HHSC or an agency operating part of the medical assistance program to continue to provide services
under a program to certain persons who are ineligible to receive those services if the cost of providing those services
to a person under the medical assistance waiver program does not exceed 133.3 percent of the individual cost limit
specified in the medical assistance waiver program, and continuation of those services does not affect compliance
with the federal cost-effectiveness and efficiency requirements of the medical assistance waiver program under 42
U.S.C. Sections 1396n(b) and 1396n(c)(2)(D).
Authorizes the executive commissioner of HHSC to adopt rules under which HHSC or an agency operating part of
the medical assistance program is authorized to exempt a person from the cost limit established under this Act.
Provides that this Act applies to a person receiving medical assistance on or after the effective date of this Act,
regardless of when eligibility for that assistance was determined.
Audits of Medicaid Providers─S.B. 630
By Senator Van de Putte—House Sponsor: Representative Gonzalez Toureilles
Currently, there are no established procedures and rules for audits of providers who contract with the Health and
Human Services Commission (HHSC) under the Medicaid program. This bill:
Amends the Human Resources Code by adding provisions relating to the auditing of providers.
Requires the executive commissioner of HHSC to adopt rules governing the audit of providers in the medical
assistance program and sets forth certain requirements for said rules.
Exempts a computerized audit conducted using the Medicaid Fraud Detection Audit system or an audit or
investigation of fraud and abuse conducted by the Medicaid fraud control unit of the office of the attorney general, the
office of the state auditor, the office of the inspector general, or the office of inspector general in the United States
Department of Health and Human Services.
Medicaid and Other Health and Human Services─S.B. 1188
By Senator Nelson—House Sponsor: Representative Delisi
During the past two legislative sessions, efforts have been made to streamline the administration of, maximize
funding for, improve recipient outcomes in, and increase the cost effectiveness of the Medicaid program. This bill:
Requires the executive commissioner of the Health and Human Services Commission (HHSC) to establish an office
of community collaboration (office).
Provides that the office is responsible for collaborating with community, state, and federal stakeholders to improve
the elements of the health care systems that are involved in the delivery of Medicaid services; and sharing with
Medicaid providers, including hospitals, any best practices, resources, or other information regarding improvements
to the health care system.
HIGHLIGHTS - 79 TH TEXAS LEGISLATURE 111