§ 36.115. RETALIATION BY EMPLOYER AGAINST PERSON BRINGING ..........

HUMAN RESOURCES CODE

CHAPTER 36. MEDICAID FRAUD PREVENTION

SUBCHAPTER A. GENERAL PROVISIONS



§ 36.001. DEFINITIONS. In this chapter:
(1) "Claim" means a written or electronically
submitted request or demand that:
(A) is signed by a provider or a fiscal agent and
that identifies a product or service provided or purported to have
been provided to a Medicaid recipient as reimbursable under the
Medicaid program, without regard to whether the money that is
requested or demanded is paid; or
(B) states the income earned or expense incurred
by a provider in providing a product or a service and that is used to
determine a rate of payment under the Medicaid program.
(2) "Documentary material" means a record, document,
or other tangible item of any form, including:
(A) a medical document or X ray prepared by a
person in relation to the provision or purported provision of a
product or service to a Medicaid recipient;
(B) a medical, professional, or business record
relating to:
(i) the provision of a product or service to
a Medicaid recipient; or
(ii) a rate or amount paid or claimed for a
product or service, including a record relating to a product or
service provided to a person other than a Medicaid recipient as
needed to verify the rate or amount;
(C) a record required to be kept by an agency that
regulates health care providers; or
(D) a record necessary to disclose the extent of
services a provider furnishes to Medicaid recipients.
(3) "Fiscal agent" means:
(A) a person who, through a contractual
relationship with the Texas Department of Human Services, the Texas
Department of Health, or another state agency, receives, processes,
and pays a claim under the Medicaid program; or
(B) the designated agent of a person described by
Paragraph (A).
(4) "Health care practitioner" means a dentist,
podiatrist, psychologist, physical therapist, chiropractor,
registered nurse, or other provider licensed to provide health care
services in this state.
(5) "Managed care organization" has the meaning
assigned by Section 32.039(a).
(6) "Medicaid program" means the state Medicaid
program.
(7) "Medicaid recipient" means an individual on whose
behalf a person claims or receives a payment from the Medicaid
program or a fiscal agent, without regard to whether the individual
was eligible for benefits under the Medicaid program.
(8) "Physician" means a physician licensed to practice
medicine in this state.
(9) "Provider" means a person who participates in or
who has applied to participate in the Medicaid program as a supplier
of a product or service and includes:
(A) a management company that manages, operates,
or controls another provider;
(B) a person, including a medical vendor, that
provides a product or service to a provider or to a fiscal agent;
(C) an employee of a provider;
(D) a managed care organization; and
(E) a manufacturer or distributor of a product
for which the Medicaid program provides reimbursement.
(10) "Service" includes care or treatment of a
Medicaid recipient.
(11) "Signed" means to have affixed a signature
directly or indirectly by means of handwriting, typewriting,
signature stamp, computer impulse, or other means recognized by
law.
(12) "Unlawful act" means an act declared to be
unlawful under Section 36.002.

Added by Acts 1995, 74th Leg., ch. 824, § 1, eff. Sept. 1, 1995.
Amended by Acts 1997, 75th Leg., ch. 1153, § 4.02, eff. Sept. 1,
1997; Acts 2005, 79th Leg., ch. 806, § 1, eff. Sept. 1, 2005.


§ 36.0011. CULPABLE MENTAL STATE. (a) For purposes of
this chapter, a person acts "knowingly" with respect to information
if the person:
(1) has knowledge of the information;
(2) acts with conscious indifference to the truth or
falsity of the information; or
(3) acts in reckless disregard of the truth or falsity
of the information.
(b) Proof of the person's specific intent to commit an
unlawful act under Section 36.002 is not required in a civil or
administrative proceeding to show that a person acted "knowingly"
with respect to information under this chapter.

Added by Acts 2005, 79th Leg., ch. 806, § 2, eff. Sept. 1, 2005.


§ 36.002. UNLAWFUL ACTS. A person commits an unlawful
act if the person:
(1) knowingly makes or causes to be made a false
statement or misrepresentation of a material fact to permit a
person to receive a benefit or payment under the Medicaid program
that is not authorized or that is greater than the benefit or
payment that is authorized;
(2) knowingly conceals or fails to disclose
information that permits a person to receive a benefit or payment
under the Medicaid program that is not authorized or that is greater
than the benefit or payment that is authorized;
(3) knowingly applies for and receives a benefit or
payment on behalf of another person under the Medicaid program and
converts any part of the benefit or payment to a use other than for
the benefit of the person on whose behalf it was received;
(4) knowingly makes, causes to be made, induces, or
seeks to induce the making of a false statement or
misrepresentation of material fact concerning:
(A) the conditions or operation of a facility in
order that the facility may qualify for certification or
recertification required by the Medicaid program, including
certification or recertification as:
(i) a hospital;
(ii) a nursing facility or skilled nursing
facility;
(iii) a hospice;
(iv) an intermediate care facility for the
mentally retarded;
(v) an assisted living facility; or
(vi) a home health agency; or
(B) information required to be provided by a
federal or state law, rule, regulation, or provider agreement
pertaining to the Medicaid program;
(5) except as authorized under the Medicaid program,
knowingly pays, charges, solicits, accepts, or receives, in
addition to an amount paid under the Medicaid program, a gift,
money, a donation, or other consideration as a condition to the
provision of a service or product or the continued provision of a
service or product if the cost of the service or product is paid
for, in whole or in part, under the Medicaid program;
(6) knowingly presents or causes to be presented a
claim for payment under the Medicaid program for a product provided
or a service rendered by a person who:
(A) is not licensed to provide the product or
render the service, if a license is required; or
(B) is not licensed in the manner claimed;
(7) knowingly makes a claim under the Medicaid program
for:
(A) a service or product that has not been
approved or acquiesced in by a treating physician or health care
practitioner;
(B) a service or product that is substantially
inadequate or inappropriate when compared to generally recognized
standards within the particular discipline or within the health
care industry; or
(C) a product that has been adulterated, debased,
mislabeled, or that is otherwise inappropriate;
(8) makes a claim under the Medicaid program and
knowingly fails to indicate the type of license and the
identification number of the licensed health care provider who
actually provided the service;
(9) knowingly enters into an agreement, combination,
or conspiracy to defraud the state by obtaining or aiding another
person in obtaining an unauthorized payment or benefit from the
Medicaid program or a fiscal agent;
(10) is a managed care organization that contracts
with the Health and Human Services Commission or other state agency
to provide or arrange to provide health care benefits or services to
individuals eligible under the Medicaid program and knowingly:
(A) fails to provide to an individual a health
care benefit or service that the organization is required to
provide under the contract;
(B) fails to provide to the commission or
appropriate state agency information required to be provided by
law, commission or agency rule, or contractual provision; or
(C) engages in a fraudulent activity in
connection with the enrollment of an individual eligible under the
Medicaid program in the organization's managed care plan or in
connection with marketing the organization's services to an
individual eligible under the Medicaid program;
(11) knowingly obstructs an investigation by the
attorney general of an alleged unlawful act under this section; or
(12) knowingly makes, uses, or causes the making or
use of a false record or statement to conceal, avoid, or decrease an
obligation to pay or transmit money or property to this state under
the Medicaid program.

Added by Acts 1995, 74th Leg., ch. 824, § 1, eff. Sept. 1, 1995.
Amended by Acts 1997, 75th Leg., ch. 1153, § 4.03, eff. Sept. 1,
1997; Acts 1999, 76th Leg., ch. 233, § 4, eff. Sept. 1, 1999;
Acts 2005, 79th Leg., ch. 806, § 3, eff. Sept. 1, 2005.


§ 36.003. DOCUMENTARY MATERIAL IN POSSESSION OF STATE
AGENCY. (a) A state agency, including the Health and Human
Services Commission, the Texas Department of Human Services, the
Texas Department of Health, the Texas Department of Mental Health
and Mental Retardation, or the Department of Protective and
Regulatory Services, shall provide the attorney general access to
all documentary materials of persons and Medicaid recipients under
the Medicaid program to which that agency has access. Documentary
material provided under this subsection is provided to permit
investigation of an alleged unlawful act or for use or potential use
in an administrative or judicial proceeding.
(b) Except as ordered by a court for good cause shown, the
office of the attorney general may not produce for inspection or
copying or otherwise disclose the contents of documentary material
obtained under this section to a person other than:
(1) an employee of the attorney general;
(2) an agency of this state, the United States, or
another state;
(3) a criminal district attorney, district attorney,
or county attorney of this state;
(4) the United States attorney general;
(5) a state or federal grand jury;
(6) a political subdivision of this state; or
(7) a person authorized by the attorney general to
receive the information.

Added by Acts 1995, 74th Leg., ch. 824, § 1, eff. Sept. 1, 1995.
Renumbered from V.T.C.A., Human Resources Code § 36.007 by Acts
1997, 75th Leg., ch. 1153, § 4.01(a) eff. Sept. 1, 1997. Amended
by Acts 2005, 79th Leg., ch. 806, § 4, eff. Sept. 1, 2005.


§ 36.004. IMMUNITY. Notwithstanding any other law, a
person is not civilly or criminally liable for providing access to
documentary material under this chapter to:
(1) an employee of the attorney general;
(2) an agency of this state, the United States, or
another state;
(3) a criminal district attorney, district attorney,
or county attorney of this state;
(4) the United States attorney general;
(5) a state or federal grand jury;
(6) a political subdivision of this state; or
(7) a person authorized by the attorney general to
receive the information.

Added by Acts 1995, 74th Leg., ch. 824, § 1, eff. Sept. 1, 1995.
Renumbered from V.T.C.A., Human Resources Code § 36.008 by Acts
1997, 75th Leg., ch. 1153, § 4.01(a), eff. Sept. 1, 1997.
Amended by Acts 2005, 79th Leg., ch. 806, § 5, eff. Sept. 1,
2005.


§ 36.005. SUSPENSION OR REVOCATION OF AGREEMENT;
PROFESSIONAL DISCIPLINE. (a) A health and human services agency,
as defined by Section 531.001, Government Code:
(1) shall suspend or revoke:
(A) a provider agreement between the agency and a
person, other than a person who operates a nursing facility or an
ICF-MR facility, found liable under Section 36.052; and
(B) a permit, license, or certification granted
by the agency to a person, other than a person who operates a
nursing facility or an ICF-MR facility, found liable under Section
36.052; and
(2) may suspend or revoke:
(A) a provider agreement between the agency and a
person who operates a nursing facility or an ICF-MR facility and who
is found liable under Section 36.052; or
(B) a permit, license, or certification granted
by the agency to a person who operates a nursing facility or an
ICF-MR facility and who is found liable under Section 36.052.
(b) A provider found liable under Section 36.052 for an
unlawful act may not, for a period of 10 years, provide or arrange
to provide health care services under the Medicaid program or
supply or sell, directly or indirectly, a product to or under the
Medicaid program. The executive commissioner of the Health and
Human Services Commission may by rule:
(1) provide for a period of ineligibility longer than
10 years; or
(2) grant a provider a full or partial exemption from
the period of ineligibility required by this subsection if the
executive commissioner finds that enforcement of the full period of
ineligibility is harmful to the Medicaid program or a beneficiary
of the program.
(b-1) The period of ineligibility begins on the date on
which the determination that the provider is liable becomes final.
(b-2) Subsections (b) and (b-1) do not apply to a provider
who operates a nursing facility or an ICF-MR facility.
(c) A person licensed by a state regulatory agency who
commits an unlawful act is subject to professional discipline under
the applicable licensing law or rules adopted under that law.
(d) For purposes of this section, a person is considered to
have been found liable under Section 36.052 if the person is found
liable in an action brought under Subchapter C.

Added by Acts 1995, 74th Leg., ch. 824, § 1, eff. Sept. 1, 1995.
Renumbered from V.T.C.A., Human Resources Code § 36.009 by Acts
1997, 75th Leg., ch. 1153, § 4.01(a), eff. Sept. 1, 1997.
Amended by Acts 1997, 75th Leg., ch. 1153, § 4.06, eff. Sept. 1,
1997; Acts 2005, 79th Leg., ch. 806, § 6, eff. Sept. 1, 2005.


§ 36.006. APPLICATION OF OTHER LAW. The application of a
civil remedy under this chapter does not preclude the application
of another common law, statutory, or regulatory remedy, except that
a person may not be liable for a civil remedy under this chapter and
civil damages or a penalty under Section 32.039 if the civil remedy
and civil damages or penalty are assessed for the same act.

Added by Acts 1995, 74th Leg., ch. 824, § 1, eff. Sept. 1, 1995.
Renumbered from V.T.C.A., Human Resources Code § 36.010 by Acts
1997, 75th Leg., ch. 1153, § 4.01(a), eff. Sept. 1, 1997.


§ 36.007. RECOVERY OF COSTS, FEES, AND EXPENSES. The
attorney general may recover fees, expenses, and costs reasonably
incurred in obtaining injunctive relief or civil remedies or in
conducting investigations under this chapter, including court
costs, reasonable attorney's fees, witness fees, and deposition
fees.

Added by Acts 1995, 74th Leg., ch. 824, § 1, eff. Sept. 1, 1995.
Renumbered from V.T.C.A., Human Resources Code § 36.011 by Acts
1997, 75th Leg., ch. 1153, § 4.01(a), eff. Sept. 1, 1997.


§ 36.008. USE OF MONEY RECOVERED. The legislature, in
appropriating money recovered under this chapter, shall consider
the requirements of the attorney general and other affected state
agencies in investigating Medicaid fraud and enforcing this
chapter.

Added by Acts 1995, 74th Leg., ch. 824, § 1, eff. Sept. 1, 1995.
Renumbered from V.T.C.A., Human Resources Code § 36.012 by Acts
1997, 75th Leg., ch. 1153, § 4.01(a), eff. Sept. 1, 1997.
SUBCHAPTER B. ACTION BY ATTORNEY GENERAL



§ 36.051. INJUNCTIVE RELIEF. (a) If the attorney general
has reason to believe that a person is committing, has committed, or
is about to commit an unlawful act, the attorney general may
institute an action for an appropriate order to restrain the person
from committing or continuing to commit the act.
(b) An action under this section shall be brought in a
district court of Travis County or of a county in which any part of
the unlawful act occurred, is occurring, or is about to occur.

Added by Acts 1995, 74th Leg., ch. 824, § 1, eff. Sept. 1, 1995.
Renumbered from V.T.C.A., Human Resources Code § 36.003 by Acts
1997, 75th Leg., ch. 1153, § 4.01(b), eff. Sept. 1, 1997.


§ 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 the Medicaid 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 $5,000 or more than $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 disabled
person, as defined by Section 48.002(a)(8)(A), or a person younger
than 18 years of age; or
(B) not less than $1,000 or more than $10,000 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, § 1, eff. Sept. 1, 1995.
Renumbered from V.T.C.A., Human Resources Code § 36.004 by Acts
1997, 75th Leg., ch. 1153, § 4.01(b), eff. Sept. 1, 1997.
Amended by Acts 1997, 75th Leg., ch. 1153, § 4.04, eff. Sept. 1,
1997; Acts 2005, 79th Leg., ch. 806, § 7, eff. Sept. 1, 2005.


§ 36.053. INVESTIGATION. (a) The attorney general may
take action under Subsection (b) if the attorney general has reason
to believe that:
(1) a person has information or custody or control of
documentary material relevant to the subject matter of an
investigation of an alleged unlawful act;
(2) a person is committing, has committed, or is about
to commit an unlawful act; or
(3) it is in the public interest to conduct an
investigation to ascertain whether a person is committing, has
committed, or is about to commit an unlawful act.
(b) In investigating an unlawful act, the attorney general
may:
(1) require the person to file on a prescribed form a
statement in writing, under oath or affirmation, as to all the facts
and circumstances concerning the alleged unlawful act and other
information considered necessary by the attorney general;
(2) examine under oath a person in connection with the
alleged unlawful act; and
(3) execute in writing and serve on the person a civil
investigative demand requiring the person to produce the
documentary material and permit inspection and copying of the
material under Section 36.054.
(c) The office of the attorney general may not release or
disclose information that is obtained under Subsection (b)(1) or
(2) or any documentary material or other record derived from the
information except:
(1) by court order for good cause shown;
(2) with the consent of the person who provided the
information;
(3) to an employee of the attorney general;
(4) to an agency of this state, the United States, or
another state;
(5) to any attorney representing the state under
Section 36.055 or in a civil action brought under Subchapter C;
(6) to a political subdivision of this state; or
(7) to a person authorized by the attorney general to
receive the information.
(d) The attorney general may use documentary material
derived from information obtained under Subsection (b)(1) or (2),
or copies of that material, as the attorney general determines
necessary in the enforcement of this chapter, including
presentation before a court.
(e) If a person fails to file a statement as required by
Subsection (b)(1) or fails to submit to an examination as required
by Subsection (b)(2), the attorney general may file in a district
court of Travis County a petition for an order to compel the person
to file the statement or submit to the examination within a period
stated by court order. Failure to comply with an order entered
under this subsection is punishable as contempt.
(f) An order issued by a district court under this section
is subject to appeal to the supreme court.

Added by Acts 1995, 74th Leg., ch. 824, § 1, eff. Sept. 1, 1995.
Renumbered from V.T.C.A., Human Resources Code § 36.005 by Acts
1997, 75th Leg., ch. 1153, § 4.01(b), eff. Sept. 1, 1997.
Amended by Acts 1997, 75th Leg., ch. 1153, § 4.05, eff. Sept. 1,
1997; Acts 2005, 79th Leg., ch. 806, § 8, eff. Sept. 1, 2005.


§ 36.054. CIVIL INVESTIGATIVE DEMAND. (a) An
investigative demand must:
(1) state the rule or statute under which the alleged
unlawful act is being investigated and the general subject matter
of the investigation;
(2) describe the class or classes of documentary
material to be produced with reasonable specificity to fairly
indicate the documentary material demanded;
(3) prescribe a return date within which the
documentary material is to be produced; and
(4) identify an authorized employee of the attorney
general to whom the documentary material is to be made available for
inspection and copying.
(b) A civil investigative demand may require disclosure of
any documentary material that is discoverable under the Texas Rules
of Civil Procedure.
(c) Service of an investigative demand may be made by:
(1) delivering an executed copy of the demand to the
person to be served or to a partner, an officer, or an agent
authorized by appointment or by law to receive service of process on
behalf of that person;
(2) delivering an executed copy of the demand to the
principal place of business in this state of the person to be
served; or
(3) mailing by registered or certified mail an
executed copy of the demand addressed to the person to be served at
the person's principal place of business in this state or, if the
person has no place of business in this state, to a person's
principal office or place of business.
(d) Documentary material demanded under this section shall
be produced for inspection and copying during normal business hours
at the office of the attorney general or as agreed by the person
served and the attorney general.
(e) The office of the attorney general may not produce for
inspection or copying or otherwise disclose the contents of
documentary material obtained under this section except:
(1) by court order for good cause shown;
(2) with the consent of the person who produced the
information;
(3) to an employee of the attorney general;
(4) to an agency of this state, the United States, or
another state;
(5) to any attorney representing the state under
Section 36.055 or in a civil action brought under Subchapter C;
(6) to a political subdivision of this state; or
(7) to a person authorized by the attorney general to
receive the information.
(e-1) The attorney general shall prescribe reasonable terms
and conditions allowing the documentary material to be available
for inspection and copying by the person who produced the material
or by an authorized representative of that person. The attorney
general may use the documentary material or copies of it as the
attorney general determines necessary in the enforcement of this
chapter, including presentation before a court.
(f) A person may file a petition, stating good cause, to
extend the return date for the demand or to modify or set aside the
demand. A petition under this section shall be filed in a district
court of Travis County and must be filed before the earlier of:
(1) the return date specified in the demand; or
(2) the 20th day after the date the demand is served.
(g) Except as provided by court order, a person on whom a
demand has been served under this section shall comply with the
terms of an investigative demand.
(h) A person who has committed an unlawful act in relation
to the Medicaid program in this state has submitted to the
jurisdiction of this state and personal service of an investigative
demand under this section may be made on the person outside of this
state.
(i) This section does not limit the authority of the
attorney general to conduct investigations or to access a person's
documentary materials or other information under another state or
federal law, the Texas Rules of Civil Procedure, or the Federal
Rules of Civil Procedure.
(j) If a person fails to comply with an investigative
demand, or if copying and reproduction of the documentary material
demanded cannot be satisfactorily accomplished and the person
refuses to surrender the documentary material, the attorney general
may file in a district court of Travis County a petition for an
order to enforce the investigative demand.
(k) If a petition is filed under Subsection (j), the court
may determine the matter presented and may enter an order to
implement this section.
(l) Failure to comply with a final order entered under
Subsection (k) is punishable by contempt.
(m) A final order issued by a district court under
Subsection (k) is subject to appeal to the supreme court.

Added by Acts 1995, 74th Leg., ch. 824, § 1, eff. Sept. 1, 1995.
Renumbered from V.T.C.A., Human Resources Code § 36.006 by Acts
1997, 75th Leg., ch. 1153, § 4.01(b), eff. Sept. 1, 1997.
Amended by Acts 2005, 79th Leg., ch. 806, § 9, eff. Sept. 1,
2005.


§ 36.055. ATTORNEY GENERAL AS RELATOR IN FEDERAL
ACTION. To the extent permitted by 31 U.S.C. Sections 3729-3733,
the attorney general may bring an action as relator under 31 U.S.C.
Section 3730 with respect to an act in connection with the Medicaid
program for which a person may be held liable under 31 U.S.C.
Section 3729. The attorney general may contract with a private
attorney to represent the state under this section.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.07(a), eff. Sept. 1,
1997.
SUBCHAPTER C. ACTION BY PRIVATE PERSONS



§ 36.101. ACTION BY PRIVATE PERSON AUTHORIZED. (a) A
person may bring a civil action for a violation of Section 36.002
for the person and for the state. The action shall be brought in the
name of the person and of the state.
(b) In an action brought under this subchapter, a person who
violates Section 36.002 is liable as provided by Section 36.052.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997.


§ 36.102. INITIATION OF ACTION. (a) A person bringing an
action under this subchapter shall serve a copy of the petition and
a written disclosure of substantially all material evidence and
information the person possesses on the attorney general in
compliance with the Texas Rules of Civil Procedure.
(b) The petition shall be filed in camera and, except as
provided by Subsection (c-1) or (d), shall remain under seal until
at least the 180th day after the date the petition is filed or the
date on which the state elects to intervene, whichever is earlier.
The petition may not be served on the defendant until the court
orders service on the defendant.
(c) The state may elect to intervene and proceed with the
action not later than the 180th day after the date the attorney
general receives the petition and the material evidence and
information.
(c-1) At the time the state intervenes, the attorney general
may file a motion with the court requesting that the petition remain
under seal for an extended period.
(d) The state may, for good cause shown, move the court to
extend the 180-day deadline under Subsection (b) or (c). A motion
under this subsection may be supported by affidavits or other
submissions in camera.
(e) An action under this subchapter may be dismissed before
the end of the period during which the petition remains under seal
only if the court and the attorney general consent in writing to the
dismissal and state their reasons for consenting.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997. Amended by Acts 2005, 79th Leg., ch. 806, § 10, eff. Sept.
1, 2005.


§ 36.103. ANSWER BY DEFENDANT. A defendant is not
required to file in accordance with the Texas Rules of Civil
Procedure an answer to a petition filed under this subchapter until
the petition is unsealed and served on the defendant.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997. Amended by Acts 2005, 79th Leg., ch. 806, § 11, eff. Sept.
1, 2005.


§ 36.104. CONTINUATION OR DISMISSAL OF ACTION BASED ON
STATE DECISION. (a) Not later than the last day of the period
prescribed by Section 36.102(c) or an extension of that period as
provided by Section 36.102(d), the state shall:
(1) proceed with the action; or
(2) notify the court that the state declines to take
over the action.
(b) If the state declines to take over the action, the court
shall dismiss the action.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997. Amended by Acts 2005, 79th Leg., ch. 806, § 12, eff. Sept.
1, 2005.


§ 36.105. REPRESENTATION OF STATE BY PRIVATE
ATTORNEY. The attorney general may contract with a private
attorney to represent the state in an action under this subchapter
with which the state elects to proceed.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997.


§ 36.106. INTERVENTION BY OTHER PARTIES PROHIBITED. A
person other than the state may not intervene or bring a related
action based on the facts underlying a pending action brought under
this subchapter.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997.


§ 36.107. RIGHTS OF PARTIES IF STATE CONTINUES
ACTION. (a) If the state proceeds with the action, the state has
the primary responsibility for prosecuting the action and is not
bound by an act of the person bringing the action. The person
bringing the action has the right to continue as a party to the
action, subject to the limitations set forth by this section.
(b) The state may dismiss the action notwithstanding the
objections of the person bringing the action if:
(1) the attorney general notifies the person that the
state has filed a motion to dismiss; and
(2) the court provides the person with an opportunity
for a hearing on the motion.
(c) The state may settle the action with the defendant
notwithstanding the objections of the person bringing the action if
the court determines, after a hearing, that the proposed settlement
is fair, adequate, and reasonable under all the circumstances. On a
showing of good cause, the hearing may be held in camera.
(d) On a showing by the state that unrestricted
participation during the course of the litigation by the person
bringing the action would interfere with or unduly delay the
state's prosecution of the case, or would be repetitious,
irrelevant, or for purposes of harassment, the court may impose
limitations on the person's participation, including:
(1) limiting the number of witnesses the person may
call;
(2) limiting the length of the testimony of witnesses
called by the person;
(3) limiting the person's cross-examination of
witnesses; or
(4) otherwise limiting the participation by the person
in the litigation.
(e) On a showing by the defendant that unrestricted
participation during the course of the litigation by the person
bringing the action would be for purposes of harassment or would
cause the defendant undue burden or unnecessary expense, the court
may limit the participation by the person in the litigation.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997.


§ 36.108. STAY OF CERTAIN DISCOVERY. (a) On a showing by
the state that certain actions of discovery by the person bringing
the action would interfere with the state's investigation or
prosecution of a criminal or civil matter arising out of the same
facts, the court may stay the discovery for a period not to exceed
60 days.
(b) The court shall hear a motion to stay discovery under
this section in camera.
(c) The court may extend the period prescribed by Subsection
(a) on a further showing in camera that the state has pursued the
criminal or civil investigation or proceedings with reasonable
diligence and that any proposed discovery in the civil action will
interfere with the ongoing criminal or civil investigation or
proceedings.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997.


§ 36.109. PURSUIT OF ALTERNATE REMEDY BY STATE. (a)
Notwithstanding Section 36.101, the state may elect to pursue the
state's claim through any alternate remedy available to the state,
including any administrative proceeding to determine an
administrative penalty. If an alternate remedy is pursued in
another proceeding, the person bringing the action has the same
rights in the other proceeding as the person would have had if the
action had continued under this subchapter.
(b) A finding of fact or conclusion of law made in the other
proceeding that has become final is conclusive on all parties to an
action under this subchapter. For purposes of this subsection, a
finding or conclusion is final if:
(1) the finding or conclusion has been finally
determined on appeal to the appropriate court;
(2) no appeal has been filed with respect to the
finding or conclusion and all time for filing an appeal has expired;
or
(3) the finding or conclusion is not subject to
judicial review.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997.


§ 36.110. AWARD TO PRIVATE PLAINTIFF. (a) If the state
proceeds with an action under this subchapter, the person bringing
the action is entitled, except as provided by Subsection (b), to
receive at least 10 percent but not more than 25 percent of the
proceeds of the action, depending on the extent to which the person
substantially contributed to the prosecution of the action.
(b) If the court finds that the action is based primarily on
disclosures of specific information, other than information
provided by the person bringing the action, relating to allegations
or transactions in a criminal or civil hearing, in a legislative or
administrative report, hearing, audit, or investigation, or from
the news media, the court may award the amount the court considers
appropriate but not more than seven percent of the proceeds of the
action. The court shall consider the significance of the
information and the role of the person bringing the action in
advancing the case to litigation.
(c) A payment to a person under this section shall be made
from the proceeds of the action. A person receiving a payment under
this section is also entitled to receive from the defendant an
amount for reasonable expenses, reasonable attorney's fees, and
costs that the court finds to have been necessarily incurred. The
court's determination of expenses, fees, and costs to be awarded
under this subsection shall be made only after the defendant has
been found liable in the action.
(d) In this section, "proceeds of the action" includes
proceeds of a settlement of the action.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997. Amended by Acts 2005, 79th Leg., ch. 806, § 13, eff. Sept.
1, 2005.


§ 36.111. REDUCTION OF AWARD. (a) If the court finds that
the action was brought by a person who planned and initiated the
violation of Section 36.002 on which the action was brought, the
court may, to the extent the court considers appropriate, reduce
the share of the proceeds of the action the person would otherwise
receive under Section 36.110, taking into account the person's role
in advancing the case to litigation and any relevant circumstances
pertaining to the violation.
(b) If the person bringing the action is convicted of
criminal conduct arising from the person's role in the violation of
Section 36.002, the court shall dismiss the person from the civil
action and the person may not receive any share of the proceeds of
the action. A dismissal under this subsection does not prejudice
the right of the state to continue the action.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997.


§ 36.112. AWARD TO DEFENDANT FOR FRIVOLOUS
ACTION. Chapter 105, Civil Practice and Remedies Code, applies in
an action under this subchapter with which the state proceeds.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997.


§ 36.113. CERTAIN ACTIONS BARRED. (a) A person may not
bring an action under this subchapter that is based on allegations
or transactions that are the subject of a civil suit or an
administrative penalty proceeding in which the state is already a
party.
(b) A person may not bring an action under this subchapter
that is based on the public disclosure of allegations or
transactions in a criminal or civil hearing, in a legislative or
administrative report, hearing, audit, or investigation, or from
the news media, unless the person bringing the action is an original
source of the information. In this subsection, "original source"
means an individual who has direct and independent knowledge of the
information on which the allegations are based and has voluntarily
provided the information to the state before filing an action under
this subchapter that is based on the information.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997.


§ 36.114. STATE NOT LIABLE FOR CERTAIN EXPENSES. The
state is not liable for expenses that a person incurs in bringing an
action under this subchapter.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997.


§ 36.115. RETALIATION BY EMPLOYER AGAINST PERSON BRINGING
SUIT PROHIBITED. (a) A person who is discharged, demoted,
suspended, threatened, harassed, or in any other manner
discriminated against in the terms of employment by the person's
employer because of a lawful act taken by the person in furtherance
of an action under this subchapter, including investigation for,
initiation of, testimony for, or assistance in an action filed or to
be filed under this subchapter, is entitled to:
(1) reinstatement with the same seniority status the
person would have had but for the discrimination; and
(2) not less than two times the amount of back pay,
interest on the back pay, and compensation for any special damages
sustained as a result of the discrimination, including litigation
costs and reasonable attorney's fees.
(b) A person may bring an action in the appropriate district
court for the relief provided in this section.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997.


§ 36.116. SOVEREIGN IMMUNITY NOT WAIVED. Except as
provided by Section 36.112, this subchapter does not waive
sovereign immunity.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997.


§ 36.117. ATTORNEY GENERAL COMPENSATION. The office of
the attorney general may retain a reasonable portion of recoveries
under this subchapter, not to exceed amounts specified in the
General Appropriations Act, for the administration of this
subchapter.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.08, eff. Sept. 1,
1997.
SUBCHAPTER D. REVOCATION OF CERTAIN OCCUPATIONAL LICENSES



§ 36.132. REVOCATION OF LICENSES. (a) In this section:
(1) "License" means a license, certificate,
registration, permit, or other authorization that:
(A) is issued by a licensing authority;
(B) is subject before expiration to suspension,
revocation, forfeiture, or termination by an issuing licensing
authority; and
(C) must be obtained before a person may practice
or engage in a particular business, occupation, or profession.
(2) "Licensing authority" means:
(A) the Texas State Board of Medical Examiners;
(B) the State Board of Dental Examiners;
(C) the Texas State Board of Examiners of
Psychologists;
(D) the Texas State Board of Social Worker
Examiners;
(E) the Board of Nurse Examiners;
(F) the Texas Board of Physical Therapy
Examiners;
(G) the Texas Board of Occupational Therapy
Examiners; or
(H) another state agency authorized to regulate a
provider who receives or is eligible to receive payment for a health
care service under the Medicaid program.
(b) A licensing authority shall revoke a license issued by
the authority to a person if the person is convicted of a felony
under Section 35A.02, Penal Code. In revoking the license, the
licensing authority shall comply with all procedures generally
applicable to the licensing authority in revoking licenses.

Added by Acts 1997, 75th Leg., ch. 1153, § 4.09, eff. Sept. 1,
1997. Amended by Acts 2003, 78th Leg., ch. 553, § 2.012, eff.
Feb. 1, 2004; Acts 2005, 79th Leg., ch. 806, § 15, eff. Sept. 1,
2005.