Texas Government Code 544.0302 – Notice
(a) The office of inspector general shall notify a provider of a payment hold imposed under § 544.0301(a) in accordance with 42 C.F.R. § 455.23(b) and, except as provided by that regulation, not later than the fifth day after the date the office imposes the payment hold.
(b) In addition to the requirements of 42 C.F.R. § 455.23(b), the payment hold notice must also include:
(1) the specific basis for the hold, including:
(A) the claims supporting the allegation at that point in the investigation;
(B) a representative sample of any documents that form the basis for the hold; and
(C) a detailed summary of the office of inspector general’s evidence relating to the allegation;
(2) a description of administrative and judicial due process rights and remedies, including:
(A) the provider’s option to seek informal resolution;
(B) the provider’s right to seek a formal administrative appeal hearing; or
(C) the provider’s ability to seek both an informal resolution and a formal administrative appeal hearing; and
(3) a detailed timeline for the provider to pursue the rights and remedies described in Subdivision (2).
Text of section effective on April 01, 2025
Terms Used In Texas Government Code 544.0302
- Allegation: something that someone says happened.
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.