Now 16 Representatives have signed onto HB 1536!

On February 20th, ten members of the House of Representatives filed a new bill, HB 1536, that allows for due process rights for all Medicaid providers.

Texas Capitol ChairsThe bill is captioned “an act relating to a Medicaid provider’s right to an administrative hearing on an action taken by the office of inspector general for the Health and Human Services Commission to recover overpayments under the Medicaid program.”

It was authored by Rep. Bobby Guerra, Rep. J.D. Sheffield, Rep. Sergio Muñoz, Jr., Rep. Philip Cortez and Rep. Cecil Bell. Bill co-authors are listed as Rep. Nicole Collier, Rep. Pancho Nevárez, Rep. John Raney, Rep. Oscar Longoria and Rep. Justin Rodriguez. Several Reps have since signed on as well, making the total 16 as of 20 March. These are Rep. Terry Canales, Rep. Roberto R. Alonzo and Rep. René O. Oliveira. Rep. Susan King, Rep. Eddie Lucio III and J.M. Lozano have now also been added as co-authors.

On February 22nd, Senator Juan “Chuy” Hinojosa introduced the same bill into the Senate, SB 785. Senator Lucio is now also a co-author.

The bill enshrines the right of a Medicaid provider accused of overbilling the program by the Office of Inspector General HHSC to obtain a hearing before the State Office of Administrative Hearings on those accusations. It also makes provision for the provider to file for a judicial review should they contest the SOHA judge’s ruling and the amount of overpayment is greater than $50,000.

Corpus Christi lawyer Tony Canales who has been representing dental Medicaid providers said,”To date, there are no effective due process rights in legislation for Medicaid providers in the state of Texas when it comes to investigations for overpayments or Medicaid fraud by the Office of the Inspector General. OIG states that they provide due process but this is just informal and they really drive the system, contrary to their assertions otherwise. Only one dental Medicaid provider to date, considering the highly public allegations of Medicaid fraud that have been thrown around for almost the last two years, has been able to get a final SOHA ruling on their case. And it was bad news for OIG.”

He was referencing the Harlingen Family Dentistry case for which he was the lawyer representing HFD.