(a) HHSC may impose an administrative penalty:
(1) for a contractor that has a contract for the HCS
Program, in accordance with §9.181 of this title (relating to
Administrative Penalties); or
(2) for a contractor that has a contract for the TxHmL
Program, in accordance with §9.581 of this title (relating to
Administrative Penalties).
(b) HHSC sends a contractor written notice if HHSC
is imposing an administrative penalty. The notice includes:
(1) for a violation described in §9.181(a)(1)
or §9.581(a)(1) of this title:
(A) the date the administrative penalty begins to accrue,
as described in §9.181(e) or §9.581(e) of this title; and
(B) the amount of the administrative penalty that will
accrue each day; or
(2) for an action described in §9.181(a)(2) or §9.581(a)(2)
of this title:
(A) the amount of the administrative penalty, as described
in §9.181(b) or §9.581(b) of this title; and
(B) the date HHSC will require the contractor to pay
HHSC the amount of the administrative penalty.
(c) For a violation described in §9.181(a)(1)
or §9.581(a)(1) of this title, HHSC gives a contractor written
notice after the administrative penalty stops accruing and any informal
dispute resolution related to the violation is completed. The notice
includes:
(1) the date the administrative penalty stopped accruing,
as described in §9.181(f) or §9.581(f) of this title;
(2) the total amount of the administrative penalty;
(3) the date HHSC will require the contractor to pay
HHSC the amount of the administrative penalty; and
(4) if the violation is not an immediate threat as
defined in §9.153 or §9.553 of this title (relating to Definitions),
a statement that:
(A) the contractor may choose amelioration as described
in §9.182 or §9.586 of this title (relating to Amelioration);
(B) to choose amelioration, the contractor must notify
HHSC of this choice, in writing, within 10 business days after the
date of HHSC's notice that the administrative penalty has stopped
accruing; and
(C) if the contractor does not notify HHSC that the
contractor is choosing amelioration within the required 10-day period
the contractor forfeits the opportunity to choose amelioration.
(d) If HHSC imposes an administrative penalty and the
contractor chooses amelioration, HHSC requires the contractor to pay
HHSC the amount of the administrative penalty only if:
(1) the contractor does not submit a plan for amelioration
as described in §9.182(d) or §9.586(d) of this title, and
the contractor:
(A) does not appeal the administrative penalty; or
(B) appeals the administrative penalty and the final
decision from the administrative hearing is favorable to HHSC;
(2) HHSC denies the plan for amelioration as described
in §9.182(h)(2) or §9.586(h)(2) of this title, and the contractor:
(A) does not appeal the administrative penalty; or
(B) appeals the administrative penalty and the final
decision from the administrative hearing is favorable to HHSC; or
(3) the contractor does not implement an approved plan
for amelioration as described in §9.182(i) or §9.586(i)
of this title and the contractor:
(A) does not appeal the issue of whether the plan was
implemented; or
(B) appeals the issue of whether the plan was implemented
and the final decision from the administrative hearing is favorable
to HHSC.
(e) If HHSC approves the plan of amelioration and the
cost of the proposed changes is less than the amount of the administrative
penalty, HHSC requires the contractor to pay HHSC the difference between
the cost of the proposed changes and the administrative penalty.
(f) If HHSC imposes an administrative penalty and the
contractor does not notify HHSC that the contractor chooses amelioration
within the required 10-day period, HHSC requires the contractor to
pay HHSC the amount of the administrative penalty:
(1) if the contractor does not appeal the administrative
penalty; or
(2) if the contractor appeals the administrative penalty
and the final decision from the administrative hearing is favorable
to HHSC.
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