SB 8 Eliminating Medicaid Fraud Sent To Governor

May 26, 2013

The Texas Senate today adopted the conference committee report for SB 8 by Texas State Senator Jane Nelson, R- Flower Mound, which enhances the state's ability to detect and prevent Medicaid fraud, waste and abuse.

"Medicaid fraud robs us of resources we desperately need to help those who truly need them. SB 8 will help to ensure that every dollar we spend for Medicaid is going to honest providers who provide proper services," said Senator Nelson. "It will also help us crack down on those who are defrauding the system and taking advantage of our Medicaid population. Texas cannot afford to let even one cent go towards fraud, waste and abuse."

The final version of the bill, which will now go to the Governor for his signature, includes provisions to:

  • Establish a unit at the Health and Human Services Commission to identify anomalies and red flags that could indicate Medicaid fraud, waste or abuse;
  • Confirm the Office of Inspector General's authority to investigate fraud, waste, and abuse across all health and human services programs;
  • Strengthen policies prohibiting the solicitation of Medicaid clients;
  • Transition medical transportation services to a regional, capitated delivery model;
  • Enhance policies to prevent inappropriate ambulance services;
  • Strengthen the standards for ambulance licensure to prevent fraudulent providers from operating in Texas; and
  • Exclude providers from the Texas Medicaid program who have been excluded from a state or federal health care program for fraudulent acts, or for injury to a child, senior, or individual with a disability.