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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. 531.114. FINANCIAL ASSISTANCE FRAUD
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(a) For purposes of establishing or maintaining the eligibility of a person and the person's family for financial assistance under Chapter 31, Human Resources Code, or for purposes of increasing or preventing a reduction in the amount of that assistance, a person may not intentionally:
(1) make a statement that the person knows is false or misleading;
(2) misrepresent, conceal, or withhold a fact; or
(3) knowingly misrepresent a statement as being true.
(b) If after an investigation the commission determines that a person violated Subsection (a), the commission shall:
(1) notify the person of the alleged violation not later than the 30th day after the date the commission completes the investigation and provide the person with an opportunity for a hearing on the matter; or
(2) refer the matter to the appropriate prosecuting attorney for prosecution.
(c) If a person waives the right to a hearing or if a hearing officer at an administrative hearing held under this section determines that a person violated Subsection (a), the person is ineligible to receive financial assistance as provided by Subsection (d). A person who a hearing officer determines violated Subsection (a) may appeal that determination by filing a petition in the district court in the county in which the violation occurred not later than the 30th day after the date the hearing officer made the determination.
(d) A person determined under Subsection (c) to have violated Subsection (a) is not eligible for financial assistance:
(1) before the first anniversary of the date of that determination, if the person has no previous violations; and
(2) permanently, if the person was previously determined to have committed a violation.
(e) If a person is convicted of a state or federal offense for conduct described by Subsection (a), or if the person is granted deferred adjudication or placed on community supervision for that conduct, the person is permanently disqualified from receiving financial assistance.
(f) This section does not affect the eligibility for financial assistance of any other member of the household of a person ineligible as a result of Subsection (d) or (e).
(g) The commission shall adopt rules as necessary to implement this section.