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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 §49.535Administrative Penalties in the HCS and TxHmL Programs

(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.


Source Note: The provisions of this §49.535 adopted to be effective April 28, 2020, 45 TexReg 2725

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