Texas Administrative Code (Last Updated: March 27,2024) |
TITLE 26. HEALTH AND HUMAN SERVICES |
PART 1. HEALTH AND HUMAN SERVICES COMMISSION |
CHAPTER 266. MEDICAID HOSPICE PROGRAM |
SUBCHAPTER B. UTILIZATION REVIEW |
SECTION 266.227. Review Decision and Notice
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(a) HHSC issues a notice of proposed recoupment under 40 TAC §49.533(c) (relating to Recoupment), if HHSC upholds or modifies a proposed recoupment after the informal review. (b) The notice of proposed recoupment includes: (1) a description of the alleged rule violations warranting the proposed recoupment; (2) the amount of the proposed recoupment; (3) HHSC's decision to uphold or modify the proposed recoupment issued after an informal review; and (4) the option for the hospice to: (A) accept the proposed recoupment; or (B) appeal the proposed recoupment as provided in 40 TAC §49.541 (relating to Contractor's Right to Appeal). Source Note: The provisions of this §266.227 adopted to be effective July 26, 2022, 47 TexReg 4331