SECTION 11.7. Penalty

(a) DADS will assess a financial penalty against a facility that:

(1) fails to timely file the monthly facility report required under §11.4 of this chapter (relating to Required Reports);

(2) files a false, erroneous, or fraudulent monthly facility report that DADS concludes resulted in the assessment of a quality assurance fee that is less than the facility should have been assessed; or

(3) fails to timely pay a quality assurance fee assessed under §11.5 of this chapter (relating to Payment and Collection of Quality Assurance Fee).

(b) A penalty assessed under this section is an amount equal to one-fourth the amount of the quality assurance fee for each month the quality assurance fee is late, not reported or unpaid.

(c) DADS will notify a facility in writing of the assessment of a penalty under this section and the amount of the penalty.

(d) DADS may make a referral to an appropriate authority in cases where it makes a good faith determination that a facility has:

(1) committed fraud in the submission of information to DADS;

(2) willfully submitted erroneous information to DADS; or

(3) violated a requirement of its license or Medicaid certification.

(e) DADS may suspend payments to a facility that fails to pay or report the quality assurance fee.

(f) The assessment of a penalty under this section does not relieve a facility from:

(1) providing services to residents in accordance with its obligations under contract or the law;

(2) paying additional quality assurance fees that may be assessed to the facility; or

(3) otherwise complying with licensure and certification requirements.

Source Note: The provisions of this §11.7 adopted to be effective March 1, 2010, 35 TexReg 873