Tex. Gov't Code § 544.0352 · Subchapter H. MANAGED CARE ORGANIZATION PREVENTION AND INVESTIGATION OF FRAUD AND ABUSE
SPECIAL INVESTIGATIVE UNIT OR CONTRACTED ENTITY TO INVESTIGATE FRAUD AND ABUSE.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) A managed care organization to which this subchapter applies shall:
(1) establish and maintain a special investigative unit within the organization to investigate fraudulent claims and other types of program abuse by recipients or enrollees, as applicable, and service providers; or
(2) contract with another entity to investigate fraudulent claims and other types of program abuse by recipients or enrollees, as applicable, and service providers.
(b) A managed care organization that contracts for the investigation of fraudulent claims and other types of program abuse by recipients or enrollees, as applicable, and service providers under Subsection (a)(2) shall file with the office of inspector general:
(1) a copy of the written contract;
(2) the names, addresses, telephone numbers, and fax numbers of the principals of the entity with which the organization contracts; and
(3) a description of the qualifications of the principals of the entity with which the organization contracts.
Notes and commentary — not statutory text
History
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/GV/htm/GV.544.htm
- Text hash
- sha256 77ea548e366d1ba50cc56d6a70c8ff8e7ac28b1b987e883c6d6c27a6fd453d20
- Composed by
- compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character
Cited by 5 provisions
Provisions in this library whose text cites Tex. Gov't Code § 544.0352. Each shows the citation as that text prints it.
Government Code
- Tex. Gov't Code § 544.0353FRAUD AND ABUSE PREVENTION PLAN.Printed as Section 544.0352(a)(2)
- Tex. Gov't Code § 544.0354ASSISTANCE AND OVERSIGHT BY OFFICE OF INSPECTOR GENERAL.Printed as Section 544.0352(a)(1) | Section 544.0352(a)(2)
- Tex. Gov't Code § 544.0355RULES.Printed as Section 544.0352(a)(1) | Section 544.0352(a)(2)
- Tex. Gov't Code § 544.0502PAYMENT RECOVERY EFFORTS BY CERTAIN PERSONS; RETENTION OF RECOVERED AMOUNTS.Printed as Section 544.0352(a)(2)
- Tex. Gov't Code § 544.0505ANNUAL REPORT ON CERTAIN FRAUD AND ABUSE RECOVERIES.Printed as Section 544.0352(a)(2)
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.