S.B. No. 2579 is a legislative bill aimed at strengthening the detection and prevention of health care and insurance fraud in Texas. It introduces new civil penalties and allows private individuals to take legal action against violators of specific provisions in the Penal Code related to fraud, with penalties ranging from $5,500 to $15,000 based on the severity of the violation. The bill amends the Government Code and Insurance Code to authorize the office of inspector general to collaborate with the Texas Department of Insurance for fraud detection. It also establishes a fraud prevention partnership involving Medicaid managed care organizations and health benefit plan issuers to enhance collaborative efforts in fraud detection.

The bill further amends the Penal Code to define offenses related to health benefit plans, including making false statements to receive unauthorized benefits, with penalties varying from Class C misdemeanors to first-degree felonies based on the monetary value of the fraud. It also modifies the Code of Criminal Procedure to allow evidence of total pecuniary loss to be introduced during the punishment phase of trials for these offenses. Additionally, the bill includes provisions to protect individuals participating in legal actions from retaliation, ensures they are entitled to reinstatement and damages, and clarifies that the state is not liable for expenses incurred by these individuals. The changes will take effect on September 1, 2025, and are applicable only to offenses committed after that date.

Statutes affected:
Introduced: Insurance Code 701.102 (Insurance Code 701)