Current through Reg. 49, No. 52; December 27, 2024
(a) HHSC may impose an administrative
penalty:
(1) for a contractor that has a
contract for the HCS Program, in accordance with § 9.181 of this title
(relating to Administrative Penalties); or
(2) for a contractor that has a contract for
the TxHmL Program, in accordance with § 9.581 of this title (relating to
Administrative Penalties).
(b) HHSC sends a contractor written notice if
HHSC is imposing an administrative penalty. The notice includes:
(1) for a violation described in §
9.181(a)(1) or § 9.581(a)(1) of this title:
(A) the date the administrative penalty
begins to accrue, as described in § 9.181(e) or § 9.581(e) of this title;
and
(B) the amount of the
administrative penalty that will accrue each day; or
(2) for an action described in § 9.181(a)(2)
or § 9.581(a)(2) of this title:
(A) the
amount of the administrative penalty, as described in § 9.181(b) or § 9.581(b)
of this title; and
(B) the date
HHSC will require the contractor to pay HHSC the amount of the administrative
penalty.
(c)
For a violation described in § 9.181(a)(1) or § 9.581(a)(1) of this title, HHSC
gives a contractor written notice after the administrative penalty stops
accruing and any informal dispute resolution related to the violation is
completed. The notice includes:
(1) the date
the administrative penalty stopped accruing, as described in § 9.181(f) or §
9.581(f) of this title;
(2) the
total amount of the administrative penalty;
(3) the date HHSC will require the contractor
to pay HHSC the amount of the administrative penalty; and
(4) if the violation is not an immediate
threat as defined in §
9.153 or §
9.553 of
this title (relating to Definitions), a statement that:
(A) the contractor may choose amelioration as
described in § 9.182 or § 9.586 of this title (relating to
Amelioration);
(B) to choose
amelioration, the contractor must notify HHSC of this choice, in writing,
within 10 business days after the date of HHSC's notice that the administrative
penalty has stopped accruing; and
(C) if the contractor does not notify HHSC
that the contractor is choosing amelioration within the required 10-day period
the contractor forfeits the opportunity to choose amelioration.
(d) If HHSC imposes an
administrative penalty and the contractor chooses amelioration, HHSC requires
the contractor to pay HHSC the amount of the administrative penalty only if:
(1) the contractor does not submit a plan for
amelioration as described in § 9.182(d) or § 9.586(d) of this title, and the
contractor:
(A) does not appeal the
administrative penalty; or
(B)
appeals the administrative penalty and the final decision from the
administrative hearing is favorable to HHSC;
(2) HHSC denies the plan for amelioration as
described in § 9.182(h)(2) or § 9.586(h)(2) of this title, and the contractor:
(A) does not appeal the administrative
penalty; or
(B) appeals the
administrative penalty and the final decision from the administrative hearing
is favorable to HHSC; or
(3) the contractor does not implement an
approved plan for amelioration as described in § 9.182(i) or § 9.586(i) of this
title and the contractor:
(A) does not appeal
the issue of whether the plan was implemented; or
(B) appeals the issue of whether the plan was
implemented and the final decision from the administrative hearing is favorable
to HHSC.
(e)
If HHSC approves the plan of amelioration and the cost of the proposed changes
is less than the amount of the administrative penalty, HHSC requires the
contractor to pay HHSC the difference between the cost of the proposed changes
and the administrative penalty.
(f)
If HHSC imposes an administrative penalty and the contractor does not notify
HHSC that the contractor chooses amelioration within the required 10-day
period, HHSC requires the contractor to pay HHSC the amount of the
administrative penalty:
(1) if the contractor
does not appeal the administrative penalty; or
(2) if the contractor appeals the
administrative penalty and the final decision from the administrative hearing
is favorable to HHSC.
