Section 27.27 - Termination, Suspension, Probation, and Reprimand of ProvidersA provider's violation or non-compliance with federal and or state Medicaid laws, rules and regulations, rules under this chapter, or Case Management and Pregnant Women policies and procedures may result in one or more of the following actions taken by the department.
(1) Notification to the Medicaid claims administrator through HHSC that the department has terminated the case management provider. Providers will receive written notice of termination. Providers who are terminated will not be approved if they reapply.(2) Suspension of a provider in accordance with the department's policies and procedures. Providers will receive written notice of suspension.(3) Probation of a provider in accordance with the department's policies and procedures. Providers will receive written notice of probation.(4) Reprimand of a provider in accordance with the department's policies and procedures. Providers will receive written notice of reprimand.(5) Report and referral to the appropriate professional licensure entity.(6) Report and referral to HHSC Office of Inspector General.(7) Report to a law enforcement agency.25 Tex. Admin. Code § 27.27
The provisions of this §27.27 adopted to be effective June 30, 2013, 38 TexReg 3985