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Texas Statutes (Last Updated: January 4, 2014) |
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GOVERNMENT CODE |
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Title 4. EXECUTIVE BRANCH |
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Subtitle I. HEALTH AND HUMAN SERVICES |
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Chapter 531. HEALTH AND HUMAN SERVICES COMMISSION |
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Subchapter C. MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD, ABUSE, OR OVERCHARGES |
Sec. 531.1061. FRAUD INVESTIGATION TRACKING SYSTEM
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(a) The commission shall use an automated fraud investigation tracking system through the commission's office of investigations and enforcement to monitor the progress of an investigation of suspected fraud, abuse, or insufficient quality of care under the state Medicaid program.
(b) For each case of suspected fraud, abuse, or insufficient quality of care identified by the learning or neural network technology required under Section 531.106, the automated fraud investigation tracking system must:
(1) receive electronically transferred records relating to the identified case from the learning or neural network technology;
(2) record the details and monitor the status of an investigation of the identified case, including maintaining a record of the beginning and completion dates for each phase of the case investigation;
(3) generate documents and reports related to the status of the case investigation; and
(4) generate standard letters to a provider regarding the status or outcome of an investigation.
(c) The commission shall require each health and human services agency that performs any aspect of the state Medicaid program to participate in the implementation and use of the automated fraud investigation tracking system.