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Texas Administrative Code (Last Updated: March 27,2024) |
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TITLE 1. ADMINISTRATION |
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PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION |
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CHAPTER 357. HEARINGS |
| SUBCHAPTER A. UNIFORM FAIR HEARING RULES |
| § 357.1. Definitions |
| § 357.3. Authority and Right to Appeal |
| § 357.5. Hearings Officer Responsibilities |
| § 357.7. Agency and Designee Responsibilities |
| § 357.9. Burden of Proof in a Fair Hearing |
| § 357.11. Notice and Continued Benefits |
| § 357.13. Appellant Rights and Responsibilities |
| § 357.15. Scheduling Hearings and Notice Requirements |
| § 357.17. Types of Hearings |
| § 357.19. Other Procedures |
| § 357.21. Interpreters in Fair Hearings |
| § 357.23. Hearings Officer Decision and Actions |
| § 357.25. Records and Confidential Information |
| SUBCHAPTER I. HEARINGS UNDER THE ADMINISTRATIVE PROCEDURE ACT |
| § 357.481. Application of this Subchapter |
| § 357.482. Definitions |
| § 357.483. Powers and Duties of the Judge |
| § 357.484. Request for a Hearing |
| § 357.485. Venue |
| § 357.486. Computation of Time |
| § 357.487. Representation of Parties |
| § 357.488. Filing and Service of Documents |
| § 357.489. Notice of Hearing |
| § 357.490. Pre-hearing Conference |
| § 357.491. Motions |
| § 357.492. Discovery and Subpoenas |
| § 357.493. Conduct of Hearing |
| § 357.494. Evidence |
| § 357.495. Default and dismissal |
| § 357.496. Summary disposition |
| § 357.497. Proposals for Decision, Exceptions, and Replies |
| § 357.498. Final Orders and Rehearing |
| SUBCHAPTER J. MEDICAID THIRD-PARTY RECOVERY |
| § 357.501. Basis and Purpose |
| § 357.502. Definitions |
| § 357.503. Distribution of Recoveries |
| § 357.504. Waiver Authority of the Commissioner |
| SUBCHAPTER K. ADMINISTRATIVE FRAUD DISQUALIFICATION HEARINGS |
| § 357.521. Introduction and Legal Basis |
| § 357.522. Designation of Hearing Officer |
| § 357.523. Disqualification of Hearing Officer |
| § 357.524. Hearing Officer's Powers and Duties |
| § 357.525. Scheduling the Hearing |
| § 357.526. Advance Notice of Hearing |
| § 357.527. Participation While Hearing is Pending |
| § 357.528. Conduct of Hearing |
| § 357.529. Attendance at Hearing |
| § 357.530. Household Member's Rights during Hearing |
| § 357.531. Consideration of the Case by the Hearing Officer |
| § 357.532. Failure of Household Member To Appear |
| § 357.533. Postponements |
| § 357.534. Recessing the Hearing |
| § 357.535. Findings of the Hearing Officer |
| § 357.536. The Hearing Record and Decision |
| § 357.537. Effect of an Administrative Determination of Intentional Program Violation |
| § 357.538. Notification of Hearing Decision and the Effect on Remaining Household Members |
| § 357.539. Court Actions in Relation to Administrative Disqualification |
| § 357.540. Presentation of the Texas Department of Human Services' (DHS's) Case |
| § 357.541. Effect of Nondetermination of Intentional Program Violation |
| § 357.542. Consolidation of Administrative Disqualification Hearings and Fair Hearings |
| SUBCHAPTER L. FRAUD INVOLVING RECIPIENTS |
| § 357.561. Terms and General Policy |
| § 357.562. Determination and Disposition of Intentional Program Violations |
| § 357.563. Eligibility during Investigation |
| § 357.564. Appeals |
| § 357.565. Referral of Food Stamp and Temporary Assistance for Needy Families (TANF) Intentional Program Violation Claims to Administrative Disqualification Hearing Officer |
| § 357.566. Collection Action on Food Stamp and Temporary Assistance for Needy Families (TANF) Intentional Program Violation Claims |
| SUBCHAPTER M. FRAUD OR ABUSE INVOLVING MEDICAL PROVIDERS |
| § 357.581. Department Responsibility |
| § 357.582. Confidentiality of Fraud or Abuse Investigation Records |
| § 357.583. Statutory Bases |
| § 357.584. Department Responsibilities in Relation to Provider Fraud and Abuse |
| § 357.585. Grounds for Fraud Referral and Administrative Sanction |
| § 357.586. Administrative Sanctions/Actions, Restitution, and Recoupment |
| § 357.587. Definitions |
| § 357.588. Administrative Sanctions and Actions |
| § 357.589. Scope of Sanction |
| § 357.590. Imposing a Sanction |
| § 357.591. Notice of Adverse Action |
| § 357.592. Informing Other Interested Parties |
| § 357.593. Provider Education |
| § 357.594. Request for Reinstatement |
| § 357.595. Obligation of Health Care Practitioners and Providers |
| SUBCHAPTER N. FRAUD OR ABUSE INVOLVING PROVIDERS (EXCEPT MEDICAL) |
| § 357.601. Responsibilities of the Department In Relation to Provider Fraud |
| § 357.602. Statutory Bases for Prosecution |
| SUBCHAPTER O. RECOVERY OF BENEFITS WRONGFULLY RECEIVED |
| § 357.621. Department Responsibility |
| § 357.622. Recovery from Providers |
| § 357.623. Recovery When Fraud Is Involved |
| SUBCHAPTER P. CIVIL MONETARY PENALTIES |
| § 357.641. Definitions |
| § 357.642. Liability |
| § 357.643. Maximum Amount |
| § 357.644. Exemptions |
| § 357.645. Determining the Amount |
| § 357.646. Assessment of a Civil Monetary Penalty |
| § 357.647. Payment of a Civil Monetary Penalty |
| § 357.648. Prohibited Use of Civil Monetary Penalties in Cost Reports or Claims |
| SUBCHAPTER Q. REIMBURSEMENT RATES FOR PROSECUTION OF INTENTIONAL PROGRAM VIOLATIONS |
| § 357.661. Rates of Reimbursement |
| SUBCHAPTER R. JUDICIAL AND ADMINISTRATIVE REVIEW OF HEARINGS |
| § 357.701. Purpose and Application |
| § 357.702. Definitions |
| § 357.703. Process and Timeframes |