Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 371 - MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY
Subchapter G - ADMINISTRATIVE ACTIONS AND SANCTIONS
Division 1 - GENERAL PROVISIONS
Section 371.1605 - Provider Responsibility
Universal Citation: 1 TX Admin Code ยง 371.1605
Current through Reg. 49, No. 38; September 20, 2024
(a) A Medicaid or other HHS provider is responsible for:
(1)
the provider's own actions and omissions; and
(2) the actions and omissions of the
provider's affiliates, employees, contractors, vendors, and agents.
(b) All persons and affiliates who participate in the Medicaid and other HHS programs are required to know:
(1) federal and state law, including rules
and regulations, that govern Medicaid or other HHS programs during the period
of time that the person participates;
(2) the portions of the Texas Medicaid
Provider Procedures Manual regarding the services that the person provides,
including provisions that are applicable to all providers;
(3) other HHS program and procedure manuals
and other official program manuals and publications;
(4) all publicly available official
interpretations, explanations, or bulletins regarding services the person
provides;
(5) the contents of any
provider enrollment agreement or application;
(6) any applicable managed care contractual
or publicly available policy provisions related to HHS program
integrity;
(7) federal sentencing
guidelines and United States Department of Health and Human Services guidelines
governing corporate compliance programs; and
(8) federal and state privacy and security
laws and regulations regarding use and disclosure of protected health
information and to have the appropriate protocols in place in the event of a
breach of these standards.
(c) A Medicaid or other HHS provider's responsibility under subsection (a)(2) of this section does not absolve the provider's affiliates, contractors, vendors, or agents from their own personal responsibility and liability.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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