Section 41.52 - Expulsion from TRS-ActiveCare(a) The trustee, acting through the executive director, may expel from participation in TRS-ActiveCare a participant who submits or causes to be submitted a false or fraudulent claim or enrollment application, or who has defrauded or attempted to defraud, any health benefits plan or pharmacy benefits plan offered under TRS-ActiveCare.(b) Upon receipt of a complaint or upon its own motion, the TRS staff may file a petition for expulsion with the executive director. The executive director may docket the petition and refer the matter for an adjudicative hearing before the State Office of Administrative Hearings or otherwise as authorized by law. If a petition is docketed, the provisions of Chapter 43 of this title (relating to Contested Cases) shall apply to the proceeding.(c) Following a hearing, the executive director may expel a person from participation in TRS-ActiveCare for a period of time not to exceed five years if the executive director finds that the person submitted or caused to be submitted a false or fraudulent claim or enrollment application or has defrauded or attempted to defraud any health benefits plan or pharmacy benefits plan offered under TRS-ActiveCare. Pursuant to the delegation of authority through this section, the order of the executive director is the final decision of TRS.34 Tex. Admin. Code § 41.52
The provisions of this §41.52 adopted to be effective December 26, 2002, 27 TexReg 12004; amended to be effective March 8, 2007, 32 TexReg 1092; amended by Texas Register, Volume 39, Number 51, December 19, 2014, TexReg 10029, eff. 12/22/2014