February 19, 2013

The Senate Committee on Health and Human Services today unanimously approved SB 8 by Senator Jane Nelson to eliminate the epidemic levels of fraud, waste and abuse in our Medicaid system. The bill now moves to the full Senate for further consideration.

"We must ensure that the money we are spending on Medicaid is going to services that Texans actually need and receive, and not to criminals who are defrauding the system," said Senator Nelson. "Every dollar that goes to fraud, waste or abuse is a dollar we can't spend on someone who truly needs it."

SB 8 confronts Medicaid fraud, which is so rampant that the Office of Inspector General has identified more than $6 billion in fraud and waste between 2004 and 2011 by:

  • Validating the Office of Inspector General's authority to detect, investigate and prevent fraud, waste and abuse across all of our health and human services programs;
  • Clarifying that a provider is ineligible to participate in Medicaid once a court finds the provider liable for Medicaid fraud;
  • Permanently excluding providers who have been excluded or debarred from another state or federal health care program for fraud or injury;
  • Strengthening the prohibitions against the solicitation of Medicaid clients;
  • Placing the Medical Transportation Program into a managed care setting; and
  • Directing the Health and Human Services Commission to reduce inappropriate use of ambulances for non-emergency transports.