Current through Reg. 49, No. 52; December 27, 2024
(a) Preliminary report. If after examining
the facts the deputy commissioner or designee responsible for the program area
affected by the violation concludes that the claim is false, the deputy
commissioner or designee issues a preliminary report. The report includes the
facts upon which the recommendation to assess a penalty were based and the
amount of the recommended penalty.
(b) Notice of intent to assess a penalty.
(1) DHS must give the person charged with
submitting a false claim a written notice of the preliminary report and DHS'
intent to assess a civil monetary penalty. The notice must include the
following information:
(A) a brief summary of
the facts;
(B) the amount of the
recommended penalty; and
(C) a
statement of the person's right to an informal review of the false claim charge
or penalty amount or both.
(2) Within 10 days of receiving the notice,
the person may send the DHS office designated in the notice either:
(A) a written consent to the report and the
recommended penalty; or
(B) a
written request for an informal DHS review. The person must specify whether he
is contesting the false claim charge or the penalty amount. He must present all
information and documentation to support his position.
(c) Informal review process. If
the person requests a review within the 10-day period, DHS conducts the review
and sends the person a written notice. The notice includes:
(1) the results of the review;
(2) the procedures to request a hearing
according to Subchapter Q of this chapter (relating to Contract
Appeals).
(d) Contract
hearing.
(1) The person may request a hearing
by writing to DHS' Hearing Division. The Hearing Division must receive the
request within 15 days after the person receives the notice specified in
subsection (c) of this section.
(2)
The hearing is conducted according to Subchapter Q of this chapter (relating to
Contract Appeals).
(e)
Notice of assessment of a civil monetary penalty. DHS assesses a penalty by
sending the person written notice of the assessment in the following
circumstances:
(1) after DHS receives the
person's written consent to the preliminary report and recommended penalty as
specified in subsections (a) and (b) of this section;
(2) if the person does not request an
informal review as specified in subsection (b)(2) of this section;
(3) if the person does not request a contract
hearing as specified in subsection (d)(1) of this section after receiving the
results of the informal review and the statement of the recommended penalty;
or
(4) if the administrative law
judge at the contract hearing orders the assessment of a civil monetary penalty
against the person.
