<<Prev Rule

Texas Administrative Code

Next Rule>>
TITLE 40SOCIAL SERVICES AND ASSISTANCE
PART 1DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 49CONTRACTING FOR COMMUNITY SERVICES
SUBCHAPTER EENFORCEMENT BY HHSC, TERMINATION BY CONTRACTOR, AND NO OFFER OF STANDARD CONTRACT BY HHSC
DIVISION 4SANCTIONS
RULE §49.532Vendor Hold

(a) HHSC imposes a vendor hold on a contractor if:

  (1) HHSC has proposed to terminate the contract and the contractor participates in attendant compensation rate enhancement as described in 1 TAC §355.112 (relating to Attendant Compensation Rate Enhancement); or

  (2) The HHSC Office of Inspector General determines that a vendor hold must be imposed in accordance with 42 CFR §455.23(a) due to a credible allegation of fraud for which an investigation is pending under the Medicaid Program.

(b) HHSC may impose a vendor hold on a contractor:

  (1) if HHSC has proposed to terminate the contract and the contractor does not participate in attendant compensation rate enhancement as described in 1 TAC §355.112;

  (2) if HHSC does not offer the contractor a standard contract when its contract expires;

  (3) if the contractor does not enter into a standard contract when its contract expires;

  (4) if the contractor terminates the contract;

  (5) if HHSC determines the contractor has not complied with the contract, including a determination of non-compliance described in §49.411(e) of this chapter (relating to Contract and Fiscal Monitoring) or §49.413(e) of this chapter (relating to Investigation);

  (6) if the contractor has not submitted or has not complied with an immediate protection plan as described in §49.511(d) of this subchapter (relating to Immediate Protection and Immediate Protection Plan);

  (7) if the contractor has not submitted or has not complied with a corrective action plan as described in §49.522(d) of this subchapter (relating to Corrective Action Plan); or

  (8) if the contractor's application packet described in §49.203(a)(3) of this chapter (relating to Provisional Contract Application Process):

    (A) contained incorrect information; or

    (B) contains information that has become incorrect and the contractor has not notified HHSC in accordance with §49.302(i) - (q) of this chapter (relating to General Requirements);

  (9) for a contractor that has a contract for the HCS Program, in accordance with §9.183 of this title (relating to Program Provider Compliance and Corrective Action); or

  (10) for a contractor that has a contract for the TxHmL Program, in accordance with §9.587 of this title (relating to Program Provider Compliance and Corrective Action).

(c) If HHSC imposes a vendor hold on a contractor in accordance with subsection (a) or (b) of this section, HHSC notifies the contractor of the vendor hold in writing. HHSC may impose a vendor hold pending an administrative hearing appealing the vendor hold.

(d) HHSC releases a vendor hold less any amounts being recouped by HHSC:

  (1) imposed in accordance with subsections (a)(1) and (b)(1) - (4) of this section if:

    (A) the contract has been terminated or expires and any amounts owed to individuals and LARs have been paid by the contractor;

    (B) HHSC withdraws the proposed contract termination; or

    (C) the contractor appeals the proposed contract termination and the final decision from the administrative hearing is favorable to the contractor;

  (2) imposed in accordance with subsection (a)(2) of this section, if the HHSC Office of Inspector General determines that HHSC must resume payment under the contract;

  (3) imposed in accordance with subsection (b)(5) - (8) of this section, if HHSC determines the contractor has resolved the reason for the vendor hold; or

  (4) imposed in accordance with subsection (b)(9) - (10) of this section if HHSC determines it may be released as described in §9.183 or §9.587 of this title.


Source Note: The provisions of this §49.532 adopted to be effective September 1, 2014, 39 TexReg 6637; amended to be effective September 1, 2018, 43 TexReg 5230; amended to be effective April 28, 2020, 45 TexReg 2725; amended to be effective December 22, 2020, 45 TexReg 9234

Link to Texas Secretary of State Home Page | link to Texas Register home page | link to Texas Administrative Code home page | link to Open Meetings home page