| (L) any grounds that would allow the division to sanction
a health care provider under the Labor Code or division rules.
(j) Response to denial of certification. Within 15
working days after receiving a written denial, a doctor may file a
written response with the division addressing the reasons the division
gave to the doctor for its denial.
(1) If the division does not receive a written response
by the 15th working day after the date the doctor received the notice,
the denial will be final effective the next day. The division will
not send further notice.
(2) If the division timely receives a written response
that disagrees with the denial, the division will review the response
and notify the doctor in writing of the commissioner's final decision.
(A) If the final decision is still a denial, the division's
final notice will provide the reasons the doctor's response did not
change the commissioner's decision to deny the doctor's application
for certification as a designated doctor.
(B) The denial will be effective the day after the
doctor receives notice of the denial, unless the notice specifies
otherwise.
(k) Request for informal conference. A designated doctor
whose renewal application is denied, or whose certification is suspended
or revoked, may either respond in writing using the procedure in subsection
(j) of this section or submit a written request for an informal conference
before the division to address those reasons.
(1) If the division does not receive a written request
for an informal conference by the 15th working day after the date
the doctor received the notice, the denial, suspension, or revocation
will be final effective the next day. The division will not send further
notice.
(2) If the division timely receives a written request
for an informal conference, it will set the informal conference to
occur no later than 31 days after it received the request.
(A) At the informal conference, the designated doctor
may present evidence that addresses the reasons the doctor was denied
certification, or the reasons the doctor's certification was suspended
or revoked, to the commissioner's designated representatives.
(B) The designated doctor may have an attorney present.
(C) At the end of the informal conference, the commissioner's
designated representatives will provide the designated doctor with
their final recommendation on the doctor's certification.
(i) If the final recommendation is still a denial,
suspension, or revocation, the commissioner's designated representatives
will provide the reasons for not certifying the doctor as a designated
doctor.
(ii) After the informal conference, the commissioner's
designated representatives will send their final recommendation to
the commissioner, who will review it and all evidence presented at
the informal conference and make a final decision.
(iii) The division will notify the designated doctor
of the commissioner's final decision in writing.
(iv) The decision will be effective the day after the
doctor receives notice of the decision, unless the notice specifies
otherwise.
|
| Source Note: The provisions of this §127.100 adopted to be effective September 1, 2012, 37 TexReg 5422; amended to be effective November 4, 2018, 43 TexReg 7149; amended to be effective April 30, 2023, 48 TexReg 2123 |
