SECTION 371.1013. Provider Enrollment Recommendations

(a) The OIG makes a recommendation on each enrollment application submitted for review in accordance with the requirements of this subchapter (relating to Provider Disclosure and Screening) and Chapter 352 of this title (relating to Medicaid and Children's Health Insurance Program Provider Enrollment), or other rule, as applicable. The recommendation is at the sole discretion of the OIG, and is not subject to administrative review or reconsideration.

(b) In making its enrollment recommendation, the OIG may consider any relevant circumstance or factor as it applies to the applicant, provider, or any person required to be disclosed in the enrollment application in accordance with this subchapter and Chapter 352 of this title, if applicable.

(c) Upon making a recommendation on a complete application, the OIG informs HHSC of its recommendation. HHSC makes the final enrollment decision after considering:

(1) the OIG's recommendation;

(2) any conditions for approval recommended by the OIG;

(3) the availability of access to care; and

(4) any other relevant facts or circumstances.

Source Note: The provisions of this §371.1013 adopted to be effective December 31, 2012, 37 TexReg 10189; amended to be effective October 1, 2015, 40 TexReg 6585; amended to be effective May 1, 2016, 41 TexReg 2941