TX HB4012

Expands health care fraud criminal offenses under Section 35A.02 of the Penal Code to include fraud against private health benefit plan issuers, not just government health care programs, covering false statements, concealment of information, fraudulent claims, and conspiracy to defraud

Establishes civil penalties for health care fraud violations ranging from $5,500 to $15,000 per violation (higher penalties when elderly persons, disabled persons, or minors are injured), plus liability for the payment amount, interest, and double damages

Creates a qui tam provision allowing private citizens to bring civil actions on behalf of themselves and the state for health care fraud, with whistleblowers entitled to receive 15-30% of proceeds depending on the state's participation level

Establishes a fraud prevention partnership between the Texas Department of Insurance and the Health and Human Services Commission office of inspector general to coordinate detection and prevention of health care fraud across private and public markets

Provides retaliation protections for whistleblowers who report fraud, entitling them to reinstatement, double back pay, and compensation for damages including attorney's fees if they face adverse employment actions