SECTION 354.2344. Notice and Appeal of Administrative Penalty

(a) HHSC will send the insurer a Notice of Administrative Penalty at least 30 days prior to the date that administrative penalties begin to accrue.

(b) The notice will contain the following information:

(1) the date on which administrative penalties begin to accrue if the information requested by HHSC is not received on or before that date; and

(2) the amount of the administrative penalty which will be assessed for each day of non-compliance after the date indicated on the notice.

(c) If the insurer does not submit the information on or before the date on which administrative penalties begin to accrue, penalties will be assessed as stated in the notice.

(d) An insurer may request a hearing in writing within 20 days of receiving written notice from HHSC of administrative penalty.

(e) If a hearing is requested, the hearing is a contested case under the Administrative Procedure Act, Texas Government Code Chapter 2001, and HHSC's formal hearing rules in Chapter 357, Subchapter I of this title (relating to Hearings Under the Administrative Procedure Act).

(f) If an insurer fails to submit a request for hearing within 20 days from the date of the notice, or fails to appear at a scheduled hearing, the right to a hearing is waived and the amount of penalties assessed per day of non-compliance is final.

(g) The order of administrative penalty will be reported to the attorney general for collection.

(h) The enforcement of the penalty may be stayed during the time the order is under judicial review if the insurer pays the penalty assessed as of the date of the order to the clerk of the court or files a supersedeas bond with the court in the amount of the penalty. An insurer who cannot afford to pay the penalty or file the bond may stay the enforcement by filing an affidavit in the manner required by the Texas Rules of Civil Procedure for a party who cannot afford to file security for costs, subject to the right of HHSC to contest the affidavit as provided by the Texas Rules of Civil Procedure.

Source Note: The provisions of this §354.2344 adopted to be effective June 28, 2000, 25 TexReg 6137; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4562; amended to be effective March 28, 2004, 29 TexReg 2867; amended to be effective February 22, 2024, 49 TexReg 855