2023 Texas Statutes › Human Resources Code › Title 2 - Human Services and Protective Services in General › Subtitle C - Assistance Programs › Chapter 36 - Health Care Program Fraud Prevention › Subchapter B. Action by Attorney General › Section 36.052. Civil Remedies

Sec. 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 payment or the value of any monetary or in-kind benefit provided under a health care program, directly or indirectly, as a result of the unlawful act, including any payment made to a third party;
(2)  interest on the amount of the payment or the value of the benefit described by Subdivision (1) at the prejudgment interest rate in effect on the day the payment or benefit was received or paid, for the period from the date the benefit was received or paid to the date that the state recovers the amount of the payment or value of the benefit;
(3)  a civil penalty of:
(A)  not less than $5,500 or the minimum amount imposed as provided by 31 U.S.C. Section 3729(a), if that amount exceeds $5,500, and not more than $15,000 or the maximum amount imposed as provided by 31 U.S.C. Section 3729(a), if that amount exceeds $15,000, for each unlawful act committed by the person that results in injury to an elderly person, as defined by Section 48.002(a)(1), a person with a disability, as defined by Section 48.002(a)(8)(A), or a person younger than 18 years of age; or
(B)  not less than $5,500 or the minimum amount imposed as provided by 31 U.S.C. Section 3729(a), if that amount exceeds $5,500, and not more than $11,000 or the maximum amount imposed as provided by 31 U.S.C. Section 3729(a), if that amount exceeds $11,000, for each unlawful act committed by the person that does not result in injury to a person described by Paragraph (A); and
(4)  two times the amount of the payment or the value of the benefit described by Subdivision (1).
(b)  In determining the amount of the civil penalty described by Subsection (a)(3), the trier of fact shall consider:
(1)  whether the person has previously violated the provisions of this chapter;
(2)  the seriousness of the unlawful act committed by the person, including the nature, circumstances, extent, and gravity of the unlawful act;
(3)  whether the health and safety of the public or an individual was threatened by the unlawful act;
(4)  whether the person acted in bad faith when the person engaged in the conduct that formed the basis of the unlawful act;  and
(5)  the amount necessary to deter future unlawful acts.
(c)  The trier of fact may assess a total of not more than two times the amount of a payment or the value of a benefit described by Subsection (a)(1) if the trier of fact finds that:
(1)  the person furnished the attorney general with all information known to the person about the unlawful act not later than the 30th day after the date on which the person first obtained the information; and
(2)  at the time the person furnished all the information to the attorney general, the attorney general had not yet begun an investigation under this chapter.
(d)  An action under this section shall be brought in Travis County or in a county in which any part of the unlawful act occurred.
(e)  The attorney general may:
(1)  bring an action for civil remedies under this section together with a suit for injunctive relief under Section 36.051;  or
(2)  institute an action for civil remedies independently of an action for injunctive relief.
Added by Acts 1995, 74th Leg., ch. 824, Sec. 1, eff. Sept. 1, 1995.  Renumbered from Human Resources Code Sec. 36.004 by Acts 1997, 75th Leg., ch. 1153, Sec. 4.01(b), eff. Sept. 1, 1997.  Amended by Acts 1997, 75th Leg., ch. 1153, Sec. 4.04, eff. Sept. 1, 1997.
Amended by:
Acts 2005, 79th Leg., Ch. 806 (S.B. 563), Sec. 7, eff. September 1, 2005.
Acts 2007, 80th Leg., R.S., Ch. 29 (S.B. 362), Sec. 1, eff. May 4, 2007.
Acts 2011, 82nd Leg., R.S., Ch. 398 (S.B. 544), Sec. 3, eff. September 1, 2011.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.183, eff. April 2, 2015.
Acts 2023, 88th Leg., R.S., Ch. 273 (S.B. 745), Sec. 8, eff. September 1, 2023.