Senate hearing on taxpayer fraud in human services spotlights hospice, Medicaid and SNAP risks
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Summary
Lawmakers opened an interim hearing on preventing fraud, waste and abuse in Texas human services with testimony from policy researchers, industry groups, the OIG and AGand dozens of public commenters raising concerns about hospice licensing, consumer-directed services and new federal SNAP rules.
The Senate Committee on Health and Human Services convened April 9 to examine how Texas can protect taxpayer dollars and shore up program integrity across Medicaid, SNAP and other state human services programs. Chair acknowledged national cases in Minnesota and California and said the interim charge will inform new policy and oversight tools.
Policy researchers and industry witnesses told the committee Texas has important strengths but also vulnerabilities. Caitlin Finley of FGA Action warned that eligibility ‘‘self‑attestation’’ and prolonged reasonable opportunity periods (ROPs) can let in improper enrollments; she said TexasSNAP error rates near 8% translate to roughly $720 million of exposure under new federal calculations.
Jamie Dudensing of the Texas Association of Health Plans stressed that Texasmanaged‑care structures (prior authorization, utilization review and SIUs) can reduce waste and abuse if guardrails stay in place; she described electronic visit verification (EVV) and prior authorization as tools that help curb inappropriate billing. By contrast, Nicholas Kleinworth of Paragon argued some states have structural incentives that attract bad actors and urged tighter enforcement and clinically based limits for high‑risk services.
The Office of Inspector General and the Attorney General described enforcement activity. OIG Inspector General Raymond Winter said the office recovered hundreds of millions of dollars in FY25 and can seek enhanced remedies (including up to triple damages and provider exclusion) where knowing misconduct is found; Amy Hilton of the Attorney Generaloutlined civil enforcement and whistleblower litigation that has led to large settlements in recent years.
Senators pressed agencies on technical and operational steps: who should host a cross‑agency data hub, how to modernize eligibility systems, whether MCO special investigative units meet contract requirements, and how the state should respond to rapid growth in hospice licenses. HHSC and TWC officials described existing data interfaces (death records, unemployment, quarterly wage files), new analytic tools and upcoming audits or targeted reviews (autism/ABA services, durable medical equipment, non‑emergency medical transportation and hospice utilization).
Public testimony ranged from industry proposals to familiesreports of denied hours and difficult appeals in consumer‑directed services, to hospice providers reporting co‑location and unusually high live‑discharge and cap‑exceedance rates. Multiple families urged clearer processes and faster remedies when state reviews reduce hours or change assessments.
Next steps: the committee asked agencies for additional data and said it will follow up on SIU compliance, agency IT modernization plans and targeted recommendations to strengthen licensing and enrollment checks. No formal votes were taken; the hearing generated a set of follow‑ups for staff and agencies.
