Text of section effective on April 01, 2025
Sec. 544.0302.  NOTICE.  (a)  The office of inspector general shall notify a provider of a payment hold imposed under Section 544.0301(a) in accordance with 42 C.F.R. Section 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. Section 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).
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.