Texas Government Code 531.106 – Learning, Neural Network, or Other Technology
Current as of: 2024 | Check for updates
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(a) The commission shall use learning, neural network, or other technology to identify and deter fraud in Medicaid throughout this state.
(b) The commission shall contract with a private or public entity to develop and implement the technology. The commission may require the entity it contracts with to install and operate the technology at locations specified by the commission, including commission offices.
Terms Used In Texas Government Code 531.106
- Contract: A legal written agreement that becomes binding when signed.
- Fraud: Intentional deception resulting in injury to another.
- Month: means a calendar month. See Texas Government Code 312.011
- Person: includes corporation, organization, government or governmental subdivision or agency, business trust, estate, trust, partnership, association, and any other legal entity. See Texas Government Code 311.005
(c) The data used for data processing shall be maintained as an independent subset for security purposes.
(d) The commission shall require each health and human services agency that performs any aspect of Medicaid to participate in the implementation and use of the technology.
(e) The commission shall maintain all information necessary to apply the technology to claims data covering a period of at least two years.
(f) The commission shall refer cases identified by the technology to the commission’s office of inspector general or the office of the attorney general, as appropriate.
(g) Each month, the technology implemented under this section must match vital statistics unit death records with Medicaid claims filed by a provider. If the commission determines that a provider has filed a claim for services provided to a person after the person’s date of death, as determined by the vital statistics unit death records, the commission shall refer the case for investigation to the commission’s office of inspector general.
Text of section effective until April 01, 2025