Texas Administrative Code
Title 25 - HEALTH SERVICES
Part 1 - DEPARTMENT OF STATE HEALTH SERVICES
Chapter 27 - CASE MANAGEMENT FOR CHILDREN AND PREGNANT WOMEN
Subchapter C - PROVIDER QUALIFICATIONS AND RESPONSIBILITIES
Section 27.27 - Termination, Suspension, Probation, and Reprimand of Providers

Universal Citation: 25 TX Admin Code ยง 27.27

Current through Reg. 49, No. 38; September 20, 2024

A provider's violation or non-compliance with federal and or state Medicaid laws, rules and regulations, rules under this chapter, or Case Management and Pregnant Women policies and procedures may result in one or more of the following actions taken by the department.

(1) Notification to the Medicaid claims administrator through HHSC that the department has terminated the case management provider. Providers will receive written notice of termination. Providers who are terminated will not be approved if they reapply.

(2) Suspension of a provider in accordance with the department's policies and procedures. Providers will receive written notice of suspension.

(3) Probation of a provider in accordance with the department's policies and procedures. Providers will receive written notice of probation.

(4) Reprimand of a provider in accordance with the department's policies and procedures. Providers will receive written notice of reprimand.

(5) Report and referral to the appropriate professional licensure entity.

(6) Report and referral to HHSC Office of Inspector General.

(7) Report to a law enforcement agency.

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.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.