AUSTIN, TX — Late yesterday at the Sunset Advisory Commission hearing, Chair Jane Nelson appointed Senator Juan "Chuy" Hinojosa as Chairman of a workgroup to study the Office of the Inspector General (OIG) to review and recommend changes to the current system used to investigate fraud in healthcare provider claims.

Senator Hinojosa issued the following statement:

"I am alarmed by the reality of the current process through which the OIG prosecutes fraud cases. It appears that healthcare providers are accused of fraud, presumed guilty, and are not given an appropriate due process finding from the OIG. This process goes beyond a lack of due process or transparency, but infringes on a healthcare provider's inherent rights. This is the opposite of our safeguarded justice system.

The Sunset Report further confirms the many concerns that have been expressed by healthcare providers and legislators in the last two years. Sunset recommends a complete overhaul of the current OIG office, practices, and policies. While I advocate for the prevention of fraud and abuse in our Medicaid system, the OIG and present structure is dysfunctional. This is not the type of system envisioned by the Legislature for due process.

I am honored to chair a workgroup to study such an important issue for our healthcare providers statewide and I thank Senator Jane Nelson for entrusting me with such an important task. I look forward to working with my colleagues in the Legislature, the OIG office, and stakeholders statewide to achieve a fair and transparent system of due process that our State can be proud of, and have an OIG that targets the healthcare providers that are defrauding our taxpayers and not those who commit clerical errors."

The agencies under sunset review that were discussed at the hearing include the Health & Human Services Commission (HHSC), the Texas Education Agency (TEA), the Texas Council for Developmental Disabilities, Governor's Committee on People with Disabilities, Texas Council on Purchasing from People with Disabilities, Texas Health Services Authority, and entry criteria for Self-Directed Semi-Independent Agencies.

The Sunset Advisory Commission is a 12 member legislative commission tasked with identifying and eliminating waste, duplication, and inefficiencies in government agencies. It is composed of five State Senators, five State Representatives, and two public members. The Commission reviews policies and programs of state agencies and recommends reforms, improvements, changes, dissolution of agencies, elimination of wasteful programs, and any other changes that are needed to ensure transparent, cost-effective, and productive state programs.

Public participation is a key aspect of the Sunset Review process. The Commission seeks public input through hearings on every agency under Sunset review and recommends actions on each agency to the full Legislature in the next Session.

###