2023 Texas Statutes › Government Code › Title 4 - Executive Branch › Subtitle I - Health and Human Services › Chapter 531 - Health and Human Services Commission › Subchapter C. Medicaid and Other Health and Human Services Fraud, Abuse, or Overcharges › Section 531.1031. Duty to Exchange Information

Text of section effective until April 01, 2025
Sec. 531.1031.  DUTY TO EXCHANGE INFORMATION.  (a)  In this section and Sections 531.1032, 531.1033, and 531.1034:
(1)  "Health care professional" means a person issued a license to engage in a health care profession.
(1-a)  "License" means a license, certificate, registration, permit, or other authorization that:
(A)  is issued by a licensing authority; and
(B)  must be obtained before a person may practice or engage in a particular business, occupation, or profession.
(1-b)  "Licensing authority" means a department, commission, board, office, or other agency of the state that issues a license.
(1-c)  "Office" means the commission's office of inspector general unless a different meaning is plainly required by the context in which the term appears.
(2)  "Participating agency" means:
(A)  the Medicaid fraud enforcement divisions of the office of the attorney general;
(B)  each licensing authority with authority to issue a license to a health care professional or managed care organization that may participate in Medicaid; and
(C)  the office.
(3)  "Provider" has the meaning assigned by Section 531.1011(10)(A).
(b)  This section applies only to criminal history record information held by a participating agency that relates to a health care professional and information held by a participating agency that relates to a health care professional or managed care organization that is the subject of an investigation by a participating agency for alleged fraud or abuse under Medicaid.
(c)  A participating agency may submit to another participating agency a written request for information described by Subsection (b) regarding a health care professional or managed care organization.  The participating agency that receives the request shall provide the requesting agency with the information regarding the health care professional or managed care organization unless:
(1)  the release of the information would jeopardize an ongoing investigation or prosecution by the participating agency with possession of the information; or
(2)  the release of the information is prohibited by other law.
(c-1)  Notwithstanding any other law, a participating agency may enter into a memorandum of understanding or agreement with another participating agency for the purpose of exchanging criminal history record information relating to a health care professional that both participating agencies are authorized to access under Chapter 411.  Confidential criminal history record information in the possession of a participating agency that is provided to another participating agency in accordance with this subsection remains confidential while in the possession of the participating agency that receives the information.
(d)  A participating agency that discovers information that may indicate fraud or abuse by a health care professional or managed care organization may provide that information to any other participating agency unless the release of the information is prohibited by other law.
(e)  Not later than the 30th day after the date the agency receives a request for information under Subsection (c), a participating agency that determines the agency is prohibited from releasing the requested information shall inform the agency requesting the information of that determination in writing.
(f)  Confidential information shared under this section remains subject to the same confidentiality requirements and legal restrictions on access to the information that are imposed by law on the participating agency that originally obtained or collected the information.  The sharing of information under this section does not affect whether the information is subject to disclosure under Chapter 552.
(g)  A participating agency that receives information from another participating agency under this section must obtain written permission from the agency that shared the information before using the information in a licensure or enforcement action.
(h)  This section does not affect the participating agencies' authority to exchange information under other law.
Added by Acts 2007, 80th Leg., R.S., Ch. 127 (S.B. 1694), Sec. 1, eff. September 1, 2007.
Amended by:
Acts 2011, 82nd Leg., R.S., Ch. 879 (S.B. 223), Sec. 3.12, eff. September 1, 2011.
Acts 2011, 82nd Leg., R.S., Ch. 879 (S.B. 223), Sec. 3.13, eff. September 1, 2011.
Acts 2011, 82nd Leg., R.S., Ch. 879 (S.B. 223), Sec. 3.14, eff. September 1, 2011.
Acts 2011, 82nd Leg., R.S., Ch. 980 (H.B. 1720), Sec. 4, eff. September 1, 2011.
Acts 2011, 82nd Leg., R.S., Ch. 980 (H.B. 1720), Sec. 5, eff. September 1, 2011.
Acts 2011, 82nd Leg., R.S., Ch. 980 (H.B. 1720), Sec. 6, eff. September 1, 2011.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.137, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 2.138, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 2.15(a), eff. September 1, 2015.
Acts 2015, 84th Leg., R.S., Ch. 945 (S.B. 207), Sec. 4, eff. September 1, 2015.
Repealed by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 3.01(2), eff. April 1, 2025.