Current through Reg. 49, No. 38; September 20, 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.
