| (a) The OIG may assess administrative penalties otherwise
authorized by law on behalf of the commission or a health and human
services agency.
(b) Any administrative penalties or damages assessed
for violations related to health care items or services that are authorized
or provided under federal law, including claims submitted by persons
for payment under the Medicaid program, are determined as provided
in Texas Human Resources Code, §32.039. The OIG will also follow
the procedures for imposing penalties or damages in Texas Human Resources
Code, §32.039, which include opportunities for a person subject
to potential penalties or damages to have an informal review and an
appeal, and apply the factors in accordance with §371.1603 of
this subchapter (relating to Legal Basis and Scope).
(c) This rule shall not be construed to deny any person
potentially subject to an administrative sanction imposed by the OIG,
including administrative damages or penalties, the right to introduce
mitigating evidence in a contested case proceeding. This rule also
shall not be construed to deny the OIG the right to introduce any
evidence supporting any of the factors described in §371.1603
of this subchapter (relating to Legal Basis and Scope) in a contested
case proceeding in which the agency seeks to impose an administrative
sanction, including administrative damages or penalties, upon a person.
(d) Due process.
(1) After service of a notice of preliminary report
recommending the assessment of an administrative penalty, a person
has a right to make a written request for an informal review not later
than the tenth day after service of the notice.
(2) After receiving written notice of the results of
an informal review, a person may make a written request for an administrative
appeal hearing no later than ten days after the date of service of
the notice.
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| Source Note: The provisions of this §371.1715 adopted to be effective October 14, 2012, 37 TexReg 7989; amended to be effective April 15, 2014, 39 TexReg 2833; amended to be effective May 1, 2016, 41 TexReg 2941; amended to be effective May 20, 2020, 45 TexReg 3259 |
