All Roll Calls
Yes: 350 • No: 72
TexasSB 103889th Legislature Regular SessionSenateWALLET
Relating to administrative remedies for certain fraud and abuse violations under Medicaid; providing administrative penalties.
Sponsored By: Candy Noble, Kevin Sparks (Republican)
Signed by Governor
Civil Remedies & LiabilitiesHuman Services--Medical AssistanceFRAUDMEDICAIDHEALTH & HUMAN SERVICES COMMISSION
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Bill Overview
Analyzed Economic Effects
6 provisions identified: 2 benefits, 3 costs, 1 mixed.
Cash awards for Medicaid fraud reporters
Beginning April 1, 2025, Texas authorizes awards for individuals who report Medicaid fraud, abuse, or overcharges. The Health and Human Services Commission may award up to 5% of a remedy recovered because of the report. No award is allowed if the commission or Texas attorney general already had independent knowledge of the activity. The commission must consider the report's value to Medicaid's financial integrity and may consider the reporter's role in the wrongdoing.
Review rights for Medicaid enforcement cases
Beginning September 1, 2025, people assessed Medicaid administrative remedies have set procedures for payment, court review, collection delays, and refunds. Seeking review without paying first requires following procedures using escrow, an appeal bond, or an affidavit about ability to pay. If a paid remedy is reduced or dropped, the commission must refund the proper amount with legal-judgment interest. Posted appeal bonds must be released when required by the review outcome. A person cannot owe both a Chapter 36 civil remedy and a Section 32.039 administrative remedy for the same act; other remedies remain available.
Broader Medicaid fraud rules for providers
Beginning September 1, 2025, Medicaid fraud remedies cover applications, requests, and demands for benefits or payments. Covered misconduct includes false claims, kickbacks, benefit misuse, improper billing, obstruction, and false records used to avoid state obligations. Managed care plans also face remedies for fraudulent enrollment or marketing, missing required benefits or information, and wrongful denials or delays. Knowing conduct includes actual knowledge, conscious indifference, or reckless disregard about whether information is true; specific intent is not required. The law also repeals two prior enforcement provisions, whose separate effects are not described in the supplied text. Prior law remains in place for earlier violations.
Medicaid violators face repayment and penalties
Beginning September 1, 2025, violators must repay improper payments or benefits, including payments to third parties, plus legal-judgment interest from the payment date. Texas may also impose a penalty up to twice the amount paid. Additional penalties are $5,000–$15,000 per violation causing injury to an elderly person, someone with a disability, or someone under 18. Other violations carry additional penalties up to $10,000 each; higher applicable federal False Claims Act maximums replace these state maximums. Each continuing day counts separately for obstruction, false records or improper avoidance of state obligations, and specified managed care misconduct.
Medicaid providers face claim cost limits
Beginning September 1, 2025, missing required Medicaid claim records can lead to repayment or a penalty up to $500 per violation. The Texas Health and Human Services Commission chooses which remedy applies. Collected remedies cannot count as allowable expenses in claims or cost reports used, or potentially used, to set Medicaid rates or payments.
Voucher signatures protected, false information excluded
Beginning September 1, 2025, a provider's signature alone does not count as fraud on a commission-prepared voucher. This protection applies when the commission calculates and prints the claim amount and sends the voucher for signature. Providers lose the protection if they knowingly supply false or misleading information or knowingly fail to correct it when given the chance.
Sponsors & Cosponsors
Sponsors
Candy Noble
House
Kevin Sparks
Republican • Senate
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
House vote • 4/29/2025
Record vote
Yes: 118 • No: 25
House vote • 4/28/2025
Record vote
Yes: 118 • No: 22
Senate vote • 3/31/2025
Record vote
Yes: 24 • No: 6
Senate vote • 3/31/2025
Record vote
Yes: 24 • No: 6
Senate vote • 3/31/2025
Record vote
Yes: 24 • No: 6
Senate vote • 3/31/2025
Record vote
Yes: 24 • No: 6
Senate vote • Unknown
Committee vote: Health & Human Services
Yes: 7 • No: 1
House vote • Unknown
Committee vote: Human Services
Yes: 11 • No: 0
Actions Timeline
Effective on 9/1/25
5/13/2025HouseSigned by the Governor
5/13/2025HouseSent to the Governor
5/1/2025HouseSigned in the House
5/1/2025HouseSigned in the Senate
4/30/2025SenateReported enrolled
4/29/2025SenateHouse passage reported
4/29/2025SenateStatement(s) of vote recorded in Journal
4/29/2025HouseRecord vote (RV#796)
4/29/2025HousePassed
4/29/2025HouseRead 3rd time
4/29/2025HouseStatement(s) of vote recorded in Journal
4/28/2025HouseRecord vote (RV#673)
4/28/2025HousePassed to 3rd reading
4/28/2025HouseRead 2nd time
4/28/2025HouseLaid out in lieu of companion (HB 2886)
4/28/2025HouseCommittee report sent to Calendars
4/28/2025HouseCommittee report distributed
4/25/2025HouseComte report filed with Committee Coordinator
4/25/2025HouseReported favorably w/o amendment(s)
4/15/2025HouseConsidered in public hearing
4/15/2025HouseReferred to Human Services
4/9/2025HouseRead first time
4/9/2025HouseReceived from the Senate
4/1/2025HouseReported engrossed
3/31/2025Senate
Bill Text
Engrossed
Enrolled
House Committee Report
Introduced
Senate Committee Report
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