(a) An applicant must disclose in its enrollment application
the identity of any person or entity as requested by HHSC.
(b) The applicant's disclosures must identify every
person whose identity must be disclosed pursuant to the Affordable
Care Act, Title 42 of the Code of Federal Regulations, or state statute
or administrative rule, as amended. Such disclosures include owners,
certain subcontractors, creditors, managers, and agents.
(c) An applicant must disclose in its enrollment application
every person that previously had an ownership or control interest
in the applicant but whose interest was transferred to another person,
if the person's former interest was transferred to an immediate family
member or to a member of the person's household and the person's former
interest was transferred within one year before or at any time after
receiving notice of any potential adverse actions by a governmental
entity against the person or against a provider for which the person
has or had an ownership or control interest.
(d) An applicant must disclose in the enrollment application
all information required by state or federal law or regulation, and
all additional information requested by HHSC or the OIG, in its discretion,
during the provider screening and enrollment process.
(e) If any information required to be disclosed under
this section changes during the processing of an enrollment application,
the applicant, provider, or person must disclose that information
pursuant to §352.21 of this title (relating to Duty to Report
Changes).
(f) A failure by an applicant, provider, or person
to meet any of the disclosure requirements specified in this section
constitutes a material non-disclosure of relevant information.
(g) The OIG may use information submitted by another
HHS agency that relates to information required to be disclosed in
lieu of requiring another submission of the same information by the
applicant, provider, or person.
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Source Note: The provisions of this §371.1005 adopted to be effective December 31, 2012, 37 TexReg 10189; amended to be effective May 1, 2016, 41 TexReg 2941; amended to be effective February 12, 2017, 42 TexReg 417 |