SUBCHAPTER K. RECOVERY AND RECOUPMENT IN CASES OF FRAUD, ABUSE, AND OVERCHARGES
Text of section effective on April 01, 2025
Sec. 544.0501. RECOVERY MONITORING SYSTEM. (a) The commission shall use an automated recovery monitoring system to monitor the collections process for a settled case of fraud, abuse, or insufficient quality of care in Medicaid.
(b) The recovery monitoring system must:
(1) monitor the collection of funds resulting from settled cases, including by recording:
(A) monetary payments received from a provider who agreed to a monetary payment plan; and
(B) deductions taken through the recoupment program from subsequent Medicaid claims the provider filed; and
(2) provide immediate notice of a provider who:
(A) agreed to a monetary payment plan or to deductions through the recoupment program from subsequent Medicaid claims; and
(B) fails to comply with the settlement agreement, including by providing notice of a provider who:
(i) does not make a scheduled payment; or
(ii) pays less than a scheduled amount.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.