Section 52.37 - Provisional Contract Application Denial(a) HHSC denies a provisional contract application if: (1) HHSC has not approved the applicant or contractor for enrollment in accordance with 1 TAC Chapter 352 (relating to Medicaid and Children's Health Insurance Program Provider Enrollment) and 1 TAC Chapter 371, Subchapter E (relating to Provider Disclosure and Screening);(2) HHSC has denied the enrollment application of the applicant or contractor, or has disenrolled the applicant or contractor, in accordance with 1 TAC Chapter 352 or Chapter 371, Subchapter E;(3) the applicant or a controlling person of the applicant is under an application denial period as described in § 49.702 of this chapter (relating to Application Denial Period);(4) the applicant or a controlling person of the applicant is under a period of exclusion in accordance with §§1128, 1128A, 1136, 1156, or 1842(j)(2) of the Social Security Act;(5) the applicant or a controlling person of the applicant is listed on: (A) the HHSC employee misconduct registry as unemployable;(B) the HHSC nurse aide registry as revoked or suspended;(C) the United States System for Award Management maintained by the General Services Administration;(D) the LEIE maintained by the United States Department of Health and Human Services, Office of Inspector General;(E) the LEIE maintained by the HHSC Office of Inspector General;(F) the Debarred Vendor List maintained by the Texas Comptroller of Public Accounts and the period of debarment has not expired; or(G) the HHS list of exclusions;(6) the applicant has not submitted a completed application packet as required by § 49.203 of this subchapter (relating to Provisional Contract Application Process);(7) the applicant does not have a license, certification, accreditation, or other document required by § 49.205 of this subchapter (relating to License, Certification, Accreditation, and Other Requirements);(8) the applicant is applying because of a change of ownership or a change of legal entity and HHSC has denied the application for change of ownership of any license required to be a contractor as described in § 49.205 of this subchapter;(9) the applicant or a controlling person of the applicant is ineligible to contract with HHSC in accordance with § 49.206 of this subchapter (relating to Ineligibility Due to Criminal History);(10) the applicant or a controlling person of the applicant is prohibited from contracting with HHSC in accordance with Chapter 79, Subchapter S, of this title (relating to Contracting Ethics);(11) the applicant does not meet a requirement described in § 49.204 of this subchapter (relating to Additional Provisional Contract Application Requirements);(12) a DSA in the CLASS Program is applying to be a CMA in the CLASS Program in the same catchment area in which the applicant is a DSA;(13) a CMA in the CLASS Program is applying to be a DSA in the CLASS Program in the same catchment area in which the applicant is a CMA;(14) the applicant is applying to be a DSA and CMA in the CLASS Program in the same catchment area;(15) the applicant is required to register with the Texas Secretary of State and the applicant's status with the Texas Secretary of State is not "in existence"; or(16) the applicant is required to pay Texas franchise tax and the applicant's right to transact business status with the Texas Comptroller of Public Accounts is not "active."(b) HHSC may deny a provisional contract application for good cause, including that: (1) the application packet contains incorrect information;(2) the applicant or a controlling person of the applicant terminated a contractual agreement with a governmental entity in a federal health care program, as defined in §1128B(f) of the Social Security Act, while an adverse action or sanction was proposed or in effect;(3) the applicant or a controlling person of the applicant terminated a contract while an action or sanction by DADS or HHSC, as described in § 49.521 or § 49.531 of this chapter (relating to Action by HHSC; Sanction by HHSC) was proposed or in effect;(4) DADS or HHSC proposed or imposed an action or sanction, as described in § 49.521 or § 49.531 of this chapter, against: (A) a contract of the applicant, contractor or a controlling person of the applicant; or(B) a contract of a person for whom the applicant or a controlling person of the applicant was a controlling person;(5) HHSC, another governmental entity, or a managed care organization contracting with a governmental entity, proposed or imposed a termination, suspension, recoupment, or penalty against:(A) a contractual agreement of the applicant or a controlling person of the applicant; or(B) a contract of a person for whom the applicant or a controlling person of the applicant was a controlling person;(6) HHSC or another governmental entity proposed or imposed a penalty, revocation, denial, termination, or suspension against a license, certification, or registration held by the applicant or a controlling person of the applicant;(7) the applicant or a controlling person of the applicant has an unresolved financial liability with HHSC or another governmental entity; or(8) the applicant or a controlling person of the applicant has been confirmed by DFPS or HHSC as having committed abuse, neglect, or exploitation.(c) If HHSC denies a provisional contract application, HHSC provides written notification to the applicant. If the applicant wants to be a contractor, the applicant must repeat the application process described in § 49.203 and § 49.204 of this subchapter.26 Tex. Admin. Code § 52.37
Transferred from 40 TAC § 49.207 Texas Register, Volume 49, Number 13, March 29, 2024, TexReg 2091, eff. 4/29/2024