Ley sobre el Fraude en el Cuidado de la Salud en Texas

CHAPTER 35A. HEALTH CARE FRAUD Sec. 35A.01. DEFINITIONS. In this chapter: (1) "Claim" means a written or electronically submitted request or demand that: (A) is submitted by a provider or the provider's agent and identifies a service or product provided or purported to have been provided to a health care recipient as reimbursable under a health care 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 service or product and is used to determine a Statute text rendered on: 1/1/2025 - 297 - PENAL CODE rate of payment under a health care program. (2) "Fiscal agent" means: (A) a person who, through a contractual relationship with a state agency or the federal government, receives, processes, and pays a claim under a health care program; or (B) the designated agent of a person described by Paragraph (A). (3) "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. (4) "Health care program" means a program funded by this state, the federal government, or both and designed to provide health care services to health care recipients, including a program that is administered in whole or in part through a managed care delivery model. (5) "Health care recipient" means an individual to whom a service or product is provided or purported to have