Texas Administrative Code
Title 26 - HEALTH AND HUMAN SERVICES
Part 1 - HEALTH AND HUMAN SERVICES COMMISSION
Chapter 52 - CONTRACTING FOR COMMUNITY SERVICES
Subchapter B - CONTRACTOR ENROLLMENT
Section 52.37 - Provisional Contract Application Denial
Universal Citation: 26 TX Admin Code ยง 52.37
Current through Reg. 49, No. 38; September 20, 2024
(a) HHSC denies a provisional contract application if:
(1) HHSC has not approved the applicant or
contractor for enrollment in accordance with 1 TAC Chapter 352 (relating to
Medicaid and Children's Health Insurance Program Provider Enrollment) and 1 TAC
Chapter 371, Subchapter E (relating to Provider Disclosure and
Screening);
(2) HHSC has denied the
enrollment application of the applicant or contractor, or has disenrolled the
applicant or contractor, in accordance with 1 TAC Chapter 352 or Chapter 371,
Subchapter E;
(3) the applicant or
a controlling person of the applicant is under an application denial period as
described in §
49.702
of this chapter (relating to Application Denial Period);
(4) the applicant or a controlling person of
the applicant is under a period of exclusion in accordance with
§§1128, 1128A, 1136, 1156, or 1842(j)(2) of the Social Security
Act;
(5) the applicant or a
controlling person of the applicant is listed on:
(A) the HHSC employee misconduct registry as
unemployable;
(B) the HHSC nurse
aide registry as revoked or suspended;
(C) the United States System for Award
Management maintained by the General Services Administration;
(D) the LEIE maintained by the United States
Department of Health and Human Services, Office of Inspector General;
(E) the LEIE maintained by the HHSC Office of
Inspector General;
(F) the Debarred
Vendor List maintained by the Texas Comptroller of Public Accounts and the
period of debarment has not expired; or
(G) the HHS list of exclusions;
(6) the applicant has not
submitted a completed application packet as required by §
49.203
of this subchapter (relating to Provisional Contract Application
Process);
(7) the applicant does
not have a license, certification, accreditation, or other document required by
§
49.205
of this subchapter (relating to License, Certification, Accreditation, and
Other Requirements);
(8) the
applicant is applying because of a change of ownership or a change of legal
entity and HHSC has denied the application for change of ownership of any
license required to be a contractor as described in §
49.205
of this subchapter;
(9) the
applicant or a controlling person of the applicant is ineligible to contract
with HHSC in accordance with §
49.206
of this subchapter (relating to Ineligibility Due to Criminal
History);
(10) the applicant or a
controlling person of the applicant is prohibited from contracting with HHSC in
accordance with Chapter 79, Subchapter S, of this title (relating to
Contracting Ethics);
(11) the
applicant does not meet a requirement described in §
49.204
of this subchapter (relating to Additional Provisional Contract Application
Requirements);
(12) a DSA in the
CLASS Program is applying to be a CMA in the CLASS Program in the same
catchment area in which the applicant is a DSA;
(13) a CMA in the CLASS Program is applying
to be a DSA in the CLASS Program in the same catchment area in which the
applicant is a CMA;
(14) the
applicant is applying to be a DSA and CMA in the CLASS Program in the same
catchment area;
(15) the applicant
is required to register with the Texas Secretary of State and the applicant's
status with the Texas Secretary of State is not "in existence"; or
(16) the applicant is required to pay Texas
franchise tax and the applicant's right to transact business status with the
Texas Comptroller of Public Accounts is not "active."
(b) HHSC may deny a provisional contract application for good cause, including that:
(1) the application packet contains incorrect
information;
(2) the applicant or a
controlling person of the applicant terminated a contractual agreement with a
governmental entity in a federal health care program, as defined in
§1128B(f) of the Social Security Act, while an adverse action or sanction
was proposed or in effect;
(3) the
applicant or a controlling person of the applicant terminated a contract while
an action or sanction by DADS or HHSC, as described in §
49.521
or §
49.531
of this chapter (relating to Action by HHSC; Sanction by HHSC) was proposed or
in effect;
(4) DADS or HHSC
proposed or imposed an action or sanction, as described in §
49.521
or §
49.531
of this chapter, against:
(A) a contract of
the applicant, contractor or a controlling person of the applicant;
or
(B) a contract of a person for
whom the applicant or a controlling person of the applicant was a controlling
person;
(5) HHSC, another
governmental entity, or a managed care organization contracting with a
governmental entity, proposed or imposed a termination, suspension, recoupment,
or penalty against:
(A) a contractual
agreement of the applicant or a controlling person of the applicant;
or
(B) a contract of a person for
whom the applicant or a controlling person of the applicant was a controlling
person;
(6) HHSC or
another governmental entity proposed or imposed a penalty, revocation, denial,
termination, or suspension against a license, certification, or registration
held by the applicant or a controlling person of the applicant;
(7) the applicant or a controlling person of
the applicant has an unresolved financial liability with HHSC or another
governmental entity; or
(8) the
applicant or a controlling person of the applicant has been confirmed by DFPS
or HHSC as having committed abuse, neglect, or exploitation.
(c) If HHSC denies a provisional contract application, HHSC provides written notification to the applicant. If the applicant wants to be a contractor, the applicant must repeat the application process described in § 49.203 and § 49.204 of this subchapter.
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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