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TITLE 26HEALTH AND HUMAN SERVICES
PART 1HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 266MEDICAID HOSPICE PROGRAM
SUBCHAPTER BUTILIZATION REVIEW
RULE §266.227Review Decision and Notice

(a) HHSC issues a notice of proposed recoupment under 40 TAC §49.533(c) (relating to Recoupment), if HHSC upholds or modifies a proposed recoupment after the informal review.

(b) The notice of proposed recoupment includes:

  (1) a description of the alleged rule violations warranting the proposed recoupment;

  (2) the amount of the proposed recoupment;

  (3) HHSC's decision to uphold or modify the proposed recoupment issued after an informal review; and

  (4) the option for the hospice to:

    (A) accept the proposed recoupment; or

    (B) appeal the proposed recoupment as provided in 40 TAC §49.541 (relating to Contractor's Right to Appeal).


Source Note: The provisions of this §266.227 adopted to be effective July 26, 2022, 47 TexReg 4331

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