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Committee hears plan to modernize administrative enforcement of Medicaid fraud statutes; OIG and hospitals seek clarity on due process and penalties
Summary
Senate Bill 1038 would update Chapter 32 of the Human Resources Code — the administrative enforcement statute for Medicaid — to align it with modern civil and criminal fraud statutes. Sponsors and the Office of Inspector General said the statute is outdated (last substantively changed in 1987) and needs modernization; hospitals, physician groups,
Senate Bill 1038 seeks to modernize the administrative enforcement statute governing Medicaid program integrity (commonly cited as Chapter 32 of the Human Resources Code). Sponsors said the existing administrative framework has not been substantively updated since 1987 while related civil and criminal fraud statutes have been modernized repeatedly.
Senator Sparks said aligning administrative enforcement with current civil and criminal statutes would clarify the Office of Inspector General’s authority, the scope of…
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