Text of section effective on April 01, 2025
Sec. 544.0205.  AWARD FOR REPORTING MEDICAID FRAUD, ABUSE, OR OVERCHARGES.  (a)  The commission may grant an award to an individual who reports activity that constitutes fraud or abuse of Medicaid funds or who reports Medicaid overcharges if the commission determines that the disclosure results in the recovery of an administrative penalty imposed under Section 32.039, Human Resources Code.  The commission may not grant an award to an individual in connection with a report if the commission or attorney general had independent knowledge of the activity the individual reported.
(b)  The commission shall determine the amount of an award.  The award may not exceed five percent of the amount of the administrative penalty imposed under Section 32.039, Human Resources Code, that resulted from the individual's disclosure.  In determining the award amount, the commission:
(1)  shall consider how important the disclosure is in ensuring the fiscal integrity of Medicaid; and
(2)  may consider whether the individual participated in the fraud, abuse, or overcharge.
(c)  A person who brings an action under Subchapter C, Chapter 36, Human Resources Code, is not eligible for an award under this section.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.