Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 266 - MEDICAID HOSPICE PROGRAM
Subchapter B - UTILIZATION REVIEW
Section 266.227 - Review Decision and Notice
Universal Citation: 26 TX Admin Code ยง 266.227
Current through Reg. 49, No. 38; September 20, 2024
(a) HHSC issues a notice of proposed recoupment under 40 TAC § 49.533(c) (relating to Recoupment), if HHSC upholds or modifies a proposed recoupment after the informal review.
(b) The notice of proposed recoupment includes:
(1) a
description of the alleged rule violations warranting the proposed
recoupment;
(2) the amount of the
proposed recoupment;
(3) HHSC's
decision to uphold or modify the proposed recoupment issued after an informal
review; and
(4) the option for the
hospice to:
(A) accept the proposed
recoupment; or
(B) appeal the
proposed recoupment as provided in 40 TAC §
49.541(relating
to Contractor's Right to Appeal).
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