SECTION 9.35. Withholding Provider Agreement Payments

If the department proposes to terminate a provider agreement and the provider requests an administrative hearing in accordance with §409.34 of this title (relating to Request for an Administrative Hearing), then the department may not terminate the provider agreement before the completion of the administrative hearing. If the department intends to terminate a provider agreement, then payments to the provider may be withheld by the department pending an administrative hearing appealing the proposed termination of the provider agreement. If the final decision of the administrative hearing is favorable to the department or the provider does not make a timely request for an administrative hearing, then payments withheld will not be made by the department to the provider. If the final decision is favorable to the provider, then payments withheld will be made by the department to the provider and provider agreement payments will be resumed by the department.

Source Note: The provisions of this §9.35 adopted to be effective June 13, 1995, 20 TexReg 3987; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8841