Hooray! SB 1803 with Trial De Novo Included Is Heading to the Full House

Senate Bill 1803 Medicaid Due Process RightsSince public testimony on Tuesday, the House Human Services Committee voted on a committee substitute for SB 1803, adding a number of clarifications and additions to the bill, and passed it 6-0, with three members not in attendance.  The bill now goes before the House.

The most significant addition to the bill is the addition of trial de novo for a Medicaid provider from which the Office of Inspector General is seeking to recover $1 million and over.  The provider can appeal a decision of the State Office of Administrative Hearings to a district court in Travis County for a trial de novo.   For a provider from which less than a million dollars is sought, the provider can request a judicial review of the SOHA decision in a Travis County district court.

This change makes the bill similar to the provisions of HB 1536 and is more comprehensive in that it sets out the full administrative procedure for Medicaid fraud investigations by the Office of the Inspector General including payment holds and overpayment hearings.

The full text of the bill as it now stands is available on the Capitol website.

This is an excellent success for Medicaid providers around the state.



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