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