Maximizing Reimbursement Under Texas Prompt Pay Laws (cont

Texas Expands Medicaid Fraud Laws (cont.)Austin100 Congress Avenue, Suite 1100Austin, Texas 78701(512) 236-2000 • fax (512) 236-2002Dallas901 Main Street, Suite 6000(214) 953-6000 • fax (214) 953-5822Fort Worth301 Commerce Street, Suite 2400Fort Worth, Texas 76102(817) 334-7200 • fax (817) 334-7290Houston1401 McKinney Street, Suite 1900Houston, Texas 77010(713) 752-4200 • fax (713) 752-4221Richardson2435 N. Central Expressway, Suite 600Richardson, Texas 75080(972) 744-2900 • fax (972) 744-290960 days after receipt of the complaint and must be completed within 90 days after the reviewis begun. If an integrity review indicates fraud or abuse involving criminal conduct by aprovider, the OIG must refer to the AG within 30 days. If the integrity review indicates that arecipient has defrauded the Medicaid program, the OIG may conduct a full investigation.HHSC is required to refer cases to the Attorney General’s Medicaid Fraud Control Unitwhenever the Commission learns or has reason to suspect that a provider’s records are beingwithheld, concealed, destroyed, fabricated, or in any way falsified. HHSC is authorized to put afacility on vendor hold without prior notice to compel the production of records to either HHSCor the Attorney General’s Medicaid Fraud Control Unit (MFCU). Unless vendor hold isrequested by the AG’s MFCU, the provider is entitled to an expedited hearing on the basis forthe vendor hold.Forfeiture of ContrabandIn a criminal prosecution, the Attorney General may seize as contraband any property that isused or intended to be used in the commission of a violation of any felony that involves theMedicaid program. The forfeited property is to be transferred to HHSC for the recovery ofamounts wrongfully obtained by the owner of the property or penalties and damages to whichHHSC is otherwise entitled.San Angelo301 West Beauregard, Suite 200San Angelo, Texas 76903(915) 481-2550 • fax (915) 481-2552San Antonio112 East Pecan Street, Suite 2100San Antonio, Texas 78205(210) 978-7700 • fax (210) 978-7790TRADITION AND INNOVATION SINCE 1887901 Main StreetSuite 6000Dallas, Texas 752026