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TITLE 1ADMINISTRATION
PART 15TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 371MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY
SUBCHAPTER GADMINISTRATIVE ACTIONS AND SANCTIONS
DIVISION 2GROUNDS FOR ENFORCEMENT
RULE §371.1661Convictions and Prohibited Acts

A person is subject to administrative actions or sanctions if the person is convicted of or engages in an act that constitutes under state or federal law:

  (1) a criminal offense related to performance of a provider agreement or program violation of Medicare, the Medicaid program, other HHS program, or any other state's Medicaid program;

  (2) a criminal offense relating to dangerous drugs, controlled substances, or any other drug-related offense, including the unlawful manufacture, distribution, prescription, dispensing, or possession of a controlled substance;

  (3) a criminal offense involving moral turpitude;

  (4) a criminal offense relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct relating to the delivery of a health care item or service;

  (5) a criminal offense relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct relating to any act or omission in a program operated or financed, in whole or in part, by any federal, state, or local government agency;

  (6) a criminal offense related to the delivery of an item or service under Medicare, the Medicaid program, other HHS program, or any other state's Medicaid program, including the performance of management or administrative services relating to the delivery of items or services under any such program;

  (7) a criminal offense related to the neglect or abuse of a patient, in connection with the delivery of a health care item or service, including any offense that the OIG concludes entailed, or resulted in, neglect or abuse of patients; or

  (8) a criminal offense related to the interference with or obstruction of any audit or investigation into an alleged criminal offense.


Source Note: The provisions of this §371.1661 adopted to be effective October 14, 2012, 37 TexReg 7989

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