Texas § GV.544.0452 - MEDICAID FRAUD INVESTIGATION TRACKING SYSTEM

§ GV.544.0452. MEDICAID FRAUD INVESTIGATION TRACKING SYSTEM

MEDICAID FRAUD INVESTIGATION TRACKING SYSTEM. (a) The commission shall use an automated fraud investigation tracking system through the office of inspector general to monitor the progress of an investigation of suspected fraud, abuse, or insufficient quality of care in Medicaid. (b) For each case of suspected fraud, abuse, or insufficient quality of care the technology required under Section 544.0451 identifies, the automated fraud investigation tracking system must: (1) receive from the technology electronically transferred records relating to the case; (2) record the details and monitor the status of an investigation of the 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 part of Medicaid to participate in implementing and using the automated fraud investigation tracking system. Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611 ), Sec. 1.01, eff. April 1, 2025.