SECTION 261.270. Suspension of Payments

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(a) DADS suspends payments owed to a program provider under a provider agreement if DADS is notified by the Health and Human Services Commission Office of Inspector General (OIG) that payments must be withheld because of receipt of reliable evidence involving fraud or willful misrepresentation under the Medicaid Program in accordance with 42 CFR §455.23(a).
(b) DADS suspends payments in accordance with subsection (a) of this section until:
(1) OIG notifies DADS that it must pay amounts suspended and resume payment under the provider agreement; or
(2) OIG notifies DADS that it must terminate the provider agreement in accordance with §9.268 of this division (relating to Termination of Provider Agreement.)

Source Note: The provisions of this §261.270 adopted to be effective November 4, 2013, 38 TexReg 7724; transferred effective October 1, 2020, as published in the Texas Register August 28, 2020, 45 TexReg 6127

                    
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