Texas Human Resources Code Title 2, Chapter 36 - Medicaid Fraud Prevention

SUBCHAPTER A GENERAL PROVISIONS

• Texas Section 36.001 - Definitions
  In this chapter: (1) "Claim" means a written or electronically submitted request or demand that: (A) is signed by a provider or a fiscal agent...
• Texas Section 36.0011 - Culpable Mental State
  (a) For purposes of this chapter, a person acts "knowingly" with respect to information if the person: (1) has knowledge of the information; (2) acts...
• Texas Section 36.002 - Unlawful Acts
  A person commits an unlawful act if the person: (1) knowingly makes or causes to be made a false statement or misrepresentation of a material...
• Texas Section 36.003 - Documentary Material In Possession Of State Agency
  (a) A state agency, including the commission, the Department of State Health Services, the Department of Aging and Disability Services, and the Department of Family...
• Texas Section 36.004 - Immunity
  Notwithstanding any other law, a person is not civilly or criminally liable for providing access to documentary material under this chapter to: (1) an employee...
• Texas Section 36.005 - Suspension Or Revocation Of Agreement; Professional Discipline
  (a) A health and human services agency, as defined by Section 531.001, Government Code: (1) shall suspend or revoke: (A) a provider agreement between the...
• Texas Section 36.006 - Application Of Other Law
  The application of a civil remedy under this chapter does not preclude the application of another common law, statutory, or regulatory remedy, except that a...
• Texas Section 36.007 - Recovery Of Costs, Fees, And Expenses
  The attorney general may recover fees, expenses, and costs reasonably incurred in obtaining injunctive relief or civil remedies or in conducting investigations under this chapter,...

SUBCHAPTER B ACTION BY ATTORNEY GENERAL

• Texas Section 36.008 - Use Of Money Recovered
  The legislature, in appropriating money recovered under this chapter, shall consider the requirements of the attorney general and other affected state agencies in investigating Medicaid...
• Texas Section 36.051 - Injunctive Relief
  (a) If the attorney general has reason to believe that a person is committing, has committed, or is about to commit an unlawful act, the...
• Texas Section 36.052 - Civil Remedies
  (a) Except as provided by Subsection (c), a person who commits an unlawful act is liable to the state for: (1) the amount of any...
• Texas Section 36.053 - Investigation
  (a) The attorney general may take action under Subsection (b) if the attorney general has reason to believe that: (1) a person has information or...
• Texas Section 36.054 - Civil Investigative Demand
  (a) An investigative demand must: (1) state the rule or statute under which the alleged unlawful act is being investigated and the general subject matter...

SUBCHAPTER C ACTION BY PRIVATE PERSONS

• Texas Section 36.055 - Attorney General As Relator In Federal Action
  To the extent permitted by 31 U.S.C. Sections 3729-3733, the attorney general may bring an action as relator under 31 U.S.C. Section 3730 with respect...
• Texas Section 36.101 - Action By Private Person Authorized
  (a) A person may bring a civil action for a violation of Section 36.002 for the person and for the state. The action shall be...
• Texas Section 36.102 - Initiation Of Action
  (a) A person bringing an action under this subchapter shall serve a copy of the petition and a written disclosure of substantially all material evidence...
• Texas Section 36.1021 - Standard Of Proof
  In an action under this subchapter, the state or person bringing the action must establish each element of the action, including damages, by a preponderance...
• Texas Section 36.103 - Answer By Defendant
  A defendant is not required to file in accordance with the Texas Rules of Civil Procedure an answer to a petition filed under this subchapter...
• Texas Section 36.104 - State Decision; Continuation Of Action
  (a) Not later than the last day of the period prescribed by Section 36.102(c) or an extension of that period as provided by Section 36.102(d),...
• Texas Section 36.105 - Representation Of State By Private Attorney
  The attorney general may contract with a private attorney to represent the state in an action under this subchapter with which the state elects to...
• Texas Section 36.106 - Intervention By Other Parties Prohibited
  A person other than the state may not intervene or bring a related action based on the facts underlying a pending action brought under this...
• Texas Section 36.107 - Rights Of Parties If State Continues Action
  (a) If the state proceeds with the action, the state has the primary responsibility for prosecuting the action and is not bound by an act...
• Texas Section 36.108 - Stay Of Certain Discovery
  (a) On a showing by the state that certain actions of discovery by the person bringing the action would interfere with the state's investigation or...
• Texas Section 36.109 - Pursuit Of Alternate Remedy By State
  (a) Notwithstanding Section 36.101, the state may elect to pursue the state's claim through any alternate remedy available to the state, including any administrative proceeding...
• Texas Section 36.110 - Award To Private Plaintiff
  (a) If the state proceeds with an action under this subchapter, the person bringing the action is entitled, except as provided by Subsection (b), to...
• Texas Section 36.111 - Reduction Of Award
  (a) If the court finds that the action was brought by a person who planned and initiated the violation of Section 36.002 on which the...
• Texas Section 36.112 - Award To Defendant For Frivolous Action
  Chapter 105, Civil Practice and Remedies Code, applies in an action under this subchapter with which the state proceeds. Added by Acts 1997, 75th Leg.,...
• Texas Section 36.113 - Certain Actions Barred
  (a) A person may not bring an action under this subchapter that is based on allegations or transactions that are the subject of a civil...
• Texas Section 36.114 - State Not Liable For Certain Expenses
  The state is not liable for expenses that a person incurs in bringing an action under this subchapter. Added by Acts 1997, 75th Leg., ch....
• Texas Section 36.115 - Retaliation Against Person Prohibited
  (a) A person, including an employee, contractor, or agent, who is discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against in the...
• Texas Section 36.116 - Sovereign Immunity Not Waived
  Except as provided by Section 36.112, this subchapter does not waive sovereign immunity. Added by Acts 1997, 75th Leg., ch. 1153, Sec. 4.08, eff. Sept....

SUBCHAPTER D REVOCATION OF CERTAIN OCCUPATIONAL LICENSES

• Texas Section 36.117 - Attorney General Compensation
  The office of the attorney general may retain a reasonable portion of recoveries under this subchapter, not to exceed amounts specified in the General Appropriations...
• Texas Section 36.132 - Revocation Of Licenses
  (a) In this section: (1) "License" means a license, certificate, registration, permit, or other authorization that: (A) is issued by a licensing authority; (B) is...

Last modified: September 28, 2016