(a) A contractor is liable to HHSC for amounts paid to the contractor for a service if the contractor has not complied with contract requirements regarding a service claim or payment for a service, including §49.305 of this chapter (relating to Records), §49.311 of this chapter (relating to Claims Payment), and other HHSC rules governing services provided under the contract.
(b) If a contractor is liable to HHSC in accordance with subsection (a) of this section, HHSC may propose to recoup funds for the amount due to HHSC.
(c) If HHSC proposes to recoup funds paid to a contractor in accordance with subsection (b) of this section, HHSC notifies the contractor of the proposed recoupment in writing before the effective date of recoupment.
(d) HHSC recoups funds paid to contractor on the date given in HHSC's notice of proposed recoupment if:
  (1) the contractor does not appeal the proposed recoupment; or
  (2) the contractor appeals the proposed recoupment and the final decision from the administrative hearing is favorable to HHSC.

Source Note: The provisions of this §52.313 adopted to be effective September 1, 2014, 39 TexReg 6637; amended to be effective September 1, 2018, 43 TexReg 5230; transferred effective April 29, 2024, as published in the March 29, 2024, issue of the Texas Register, 49 TexReg 2091