All Roll Calls
Yes: 433 • No: 1
TexasHB 14289th Legislature Regular SessionHouse
Relating to the Health and Human Services Commission's office of inspector general, the review of certain Medicaid claims, and the recovery of certain overpayments under Medicaid.
Sponsored By: Carrie Isaac, Candy Noble, Charles Perry (Republican)
Signed by Governor
Electronic Information SystemsHuman Services--Medical AssistanceMEDICAIDWITNESSESHEALTH & HUMAN SERVICES COMMISSIONINSPECTOR GENERAL FOR HEALTH & HUMAN SERVICES
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 3 benefits, 0 costs, 1 mixed.
Medicaid providers face broader payment audits
Beginning September 1, 2025, Texas must use Medicaid recovery audit contractors to the extent federal law requires. Contractors identify underpayments and overpayments, including in managed care, and recover overpayments from providers or managed care organizations. Reviewed providers and plans must submit all needed information by the requested deadline; collected records remain confidential. Implementation requires dedicated funding unless the agency chooses to use other available funds. Agencies must request any needed federal approval and may delay affected provisions until approval arrives.
Texas strengthens health program fraud oversight
Beginning September 1, 2025, Texas’s health inspector general may share oversight information to carry out the office’s duties. Recipients include government agencies, law enforcement, prosecutors, and other people authorized by the office. Qualified experts hired by the commission for the office count as expert witnesses under state procurement law. Health agencies must maintain and promote a fraud-reporting system, replacing the specific toll-free hotline requirement without requiring a particular format. The law also requires strong publicity for successful fraud prosecutions and fraud-prevention programs.
Fewer fingerprint checks for licensed Medicaid professionals
Beginning September 1, 2025, the inspector general generally cannot use fingerprint checks to decide a licensed professional’s Medicaid provider eligibility. This protection applies only after the office confirms the professional is licensed and in good standing. Federally required checks remain allowed, as do checks for other appropriate purposes, including fraud, waste, or abuse investigations.
Medicaid audits face limits and appeals
Beginning September 1, 2025, recovery audit contractors need inspector general approval and a finding that a review is cost-effective. They must also wait at least one year after a claim is received before starting review. Contractors cannot start recovery when a managed care organization has notified the office that it is auditing that claim. The executive commissioner must set rules for appealing contractor-identified overpayments. The commission may hire third parties to administer appeals.
Sponsors & Cosponsors
Sponsors
Carrie Isaac
House
Candy Noble
House
Charles Perry
Republican • Senate
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
House vote • 5/19/2025
Record vote
Yes: 123 • No: 1
Senate vote • 5/8/2025
Record vote
Yes: 0 • No: 0
Senate vote • 5/8/2025
Record vote
Yes: 0 • No: 0
House vote • 4/16/2025
Record vote
Yes: 144 • No: 0
House vote • 4/15/2025
Record vote
Yes: 146 • No: 0
Senate vote • Unknown
Committee vote: Health & Human Services
Yes: 9 • No: 0
House vote • Unknown
Committee vote: Human Services
Yes: 11 • No: 0
Actions Timeline
Effective on 9/1/25
5/29/2025HouseSigned by the Governor
5/29/2025HouseSent to the Governor
5/20/2025HouseSigned in the Senate
5/20/2025SenateHouse concurs in Senate amendment(s)-reported
5/20/2025SenateSigned in the House
5/20/2025HouseReported enrolled
5/19/2025HouseText of Senate Amendment(s)
5/19/2025HouseStatement(s) of vote recorded in Journal
5/19/2025HouseRecord vote (RV#2991)
5/19/2025HouseHouse concurs in Senate amendment(s)
5/19/2025HouseSenate Amendments Analysis distributed
5/8/2025HouseSenate Amendments distributed
5/8/2025HouseSenate passage as amended reported
5/8/2025HouseRecord vote
5/8/2025SenatePassed
5/8/2025SenateRead 3rd time
5/8/2025SenateRecord vote
5/8/2025SenateThree day rule suspended
5/8/2025SenateVote recorded in Journal
5/8/2025SenateRead 2nd time & passed to 3rd reading
5/8/2025SenateRules suspended-Regular order of business
5/8/2025SenatePlaced on intent calendar
5/7/2025SenateCommittee report printed and distributed
5/5/2025SenateRecommended for local & uncontested calendar
5/5/2025Senate
Bill Text
Engrossed
Enrolled
House Committee Report
Introduced
Senate Committee Report
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