| (a) A person who is served with final notice of a sanction
may appeal the imposition of the sanction.
(b) Request for hearing.
(1) A request for an administrative hearing at HHSC
Appeals Division or at SOAH on a final notice of overpayment, must
be received in writing by the OIG no later than 30 days after the
date the person is served the final notice.
(2) A request for an administrative hearing at HHSC
Appeals Division on a Final Notice of Contract Cancellation, Final
Notice of Exclusion, or Notice of Final Assessment of Administrative
Penalties must be received in writing by the OIG no later than 15
days after the date the person is served the notice.
(3) A request for an expedited administrative hearing
at SOAH on a payment hold must be received in writing by the OIG no
later than ten days after the date the person is served the notice.
(4) A written request for an administrative hearing
must:
(A) be sent by certified mail to the address specified
in the notice letter;
(B) timely arrive at the address specified in the final
notice; and
(C) be signed by the person or an attorney for the
person. No other person or party may request a hearing for or on behalf
of the subject of the sanction.
(5) Other than a final notice of overpayment or payment
hold, an administrative hearing for a final notice of a sanction is
held at the HHSC Appeals Division.
(6) The costs for an administrative hearing held at
SOAH is borne by the OIG, but a provider is responsible for the provider's
own costs incurred in preparing for the hearing.
(7) All other costs incurred by either party, including
attorney's fees, transcript copies, expert fees, and deposition costs,
is the responsibility of the party incurring those costs.
(8) The OIG contacts the HHSC Appeals Division or SOAH
to request that the hearing be docketed. The OIG files a docketing
request for a payment hold hearing with SOAH not later than the third
day after the hearing is requested.
(c) If a person who has been served notice of a final
sanction or notice of a payment hold fails to timely request an administrative
hearing, the sanction becomes final and unappealable.
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| Source Note: The provisions of this §371.1615 adopted to be effective October 14, 2012, 37 TexReg 7989; amended to be effective April 15, 2014, 39 TexReg 2833; amended to be effective October 1, 2015, 40 TexReg 6585; amended to be effective May 1, 2016, 41 TexReg 2941 |
