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TITLE 1ADMINISTRATION
PART 15TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 352MEDICAID AND CHILDREN'S HEALTH INSURANCE PROGRAM PROVIDER ENROLLMENT
RULE §352.19Temporary Moratoria

(a) HHSC or its designee may enforce temporary moratoria imposed pursuant to the requirements of §1867 and §1902 of the Social Security Act (42 CFR, §455.470 and §457.990) on enrollment of new providers or suppliers or impose numerical caps or other limits.

(b) HHSC may determine to impose a temporary moratorium in the Texas Medicaid and CHIP programs based on provider or supplier type, geographical area, new practice locations, or a category of provider or supplier identified as having an increased risk or a potential risk of fraud, waste, or abuse, with the concurrence of the Secretary of Health and Human Services.

(c) A temporary moratorium that is imposed in accordance with this section will be for an initial period of six months, and may be extended in six-month increments at the direction of or in concurrence with the Secretary of Health and Human Services.

(d) HHSC will not process an application if a moratorium or other limit on enrollment is in effect. If an enrollment application is denied solely as the result of a temporary moratorium, HHSC will refund any application fee submitted with the enrollment application.


Source Note: The provisions of this §352.19 adopted to be effective December 31, 2012, 37 TexReg 9899

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