§ 531.101 Award for Reporting Medicaid Fraud, Abuse, or Overcharges
§ 531.1011 Definitions
§ 531.102 Office of Inspector General
§ 531.1021 Subpoenas
§ 531.1022 Peace Officers
§ 531.1023 Compliance With Federal Coding Guidelines
§ 531.1024 Hospital Utilization Reviews and Audits: Provider Education Process
§ 531.1025 Performance Audits and Coordination of Audit Activities
§ 531.103 Interagency Coordination
§ 531.1031 Duty to Exchange Information
§ 531.1032 Office of Inspector General: Criminal History Record Information Check
§ 531.1033 Monitoring of Certain Federal Databases
§ 531.1034 Time to Determine Provider Eligibility; Performance Metrics
§ 531.104 Assisting Investigations by Attorney General
§ 531.105 Fraud Detection Training
§ 531.106 Learning, Neural Network, or Other Technology
§ 531.1061 Fraud Investigation Tracking System
§ 531.1062 Recovery Monitoring System
§ 531.108 Fraud Prevention
§ 531.1081 Integrity of Certain Public Assistance Programs
§ 531.109 Selection and Review of Claims
§ 531.110 Electronic Data Matching Program
§ 531.111 Fraud Detection Technology
§ 531.1112 Study Concerning Increased Use of Technology to Strengthen Fraud Detection and Deterrence; Implementation
§ 531.112 Expunction of Information Related to Certain Chemical Dependency Diagnoses in Certain Records
§ 531.113 Managed Care Organizations: Special Investigative Units or Contracts
§ 531.1131 Fraud and Abuse Recovery by Certain Persons; Retention of Recovered Amounts
§ 531.1132 Annual Report On Certain Fraud and Abuse Recoveries
§ 531.1135 Managed Care Organizations: Process to Recoup Certain Overpayments
§ 531.114 Financial Assistance Fraud
§ 531.115 Federal Felony Match
§ 531.116 Compliance With Law Prohibiting Solicitation
§ 531.117 Recovery Audit Contractors
§ 531.118 Preliminary Investigations of Allegations of Fraud or Abuse and Fraud Referrals
§ 531.119 Website Posting
§ 531.120 Notice and Informal Resolution of Proposed Recoupment of Overpayment or Debt
§ 531.1201 Appeal of Determination to Recoup Overpayment or Debt
§ 531.1202 Record and Confidentiality of Informal Resolution Meetings
§ 531.1203 Rights of and Provision of Information to Pharmacies Subject to Certain Audits

Terms Used In Texas Government Code Chapter 531 > Subchapter C - Medicaid and Other Health and Human Services Fraud, Abuse, or Overcharges

  • Allegation: something that someone says happened.
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Comptroller: means the state comptroller of public accounts. See Texas Government Code 312.011
  • Continuance: Putting off of a hearing ot trial until a later time.
  • Contract: A legal written agreement that becomes binding when signed.
  • Conviction: A judgement of guilt against a criminal defendant.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Docket: A log containing brief entries of court proceedings.
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Fraud: Intentional deception resulting in injury to another.
  • in writing: includes any representation of words, letters, or figures, whether by writing, printing, or other means. See Texas Government Code 312.011
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Justice: when applied to a magistrate, means justice of the peace. See Texas Government Code 312.011
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
  • Month: means a calendar month. See Texas Government Code 312.011
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • 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
  • Personal property: All property that is not real property.
  • Probable cause: A reasonable ground for belief that the offender violated a specific law.
  • Property: means real and personal property. See Texas Government Code 311.005
  • Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government.
  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
  • Rule: includes regulation. See Texas Government Code 311.005
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • Signed: includes any symbol executed or adopted by a person with present intention to authenticate a writing. See Texas Government Code 311.005
  • Statute: A law passed by a legislature.
  • Subpoena: A command to a witness to appear and give testimony.
  • Testify: Answer questions in court.
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • United States: includes a department, bureau, or other agency of the United States of America. See Texas Government Code 311.005
  • Written: includes any representation of words, letters, symbols, or figures. See Texas Government Code 311.005
  • Year: means 12 consecutive months. See Texas Government Code 311.005