Sec. 32.0215. HOME OR COMMUNITY CARE PROVIDERS: CIVIL MONETARY PENALTIES. (a) The commission may include in a contract for the delivery of medical assistance by a home or community care provider a provision for monetary penalties to be assessed for a contract violation or any violation of home or community care requirements, as required by 42 U.S.C. Section 1396t(j).
(b) The executive commissioner shall adopt rules governing the application of civil money penalties, including rules prescribing:
(1) criteria that describe when and how a civil money penalty may be assessed and the amount of the penalty;
(2) a system to ensure standard and consistent application of the penalties throughout the state; and
(3) an administrative appeals process to adjudicate claims in contested cases in accordance with Chapter 2001, Government Code.
(c) Rules adopted under this section must be designed to minimize the time between the identification of a violation and the final imposition of a penalty. Rules adopted under this section may authorize the imposition of a penalty that assesses and collects a monetary penalty, with interest, for a minimum penalty period and on a subsequent per diem basis.
(d) A penalty must be appropriate to the violation. The commission may assess incrementally more severe penalties for repeated or uncorrected violations.
(e) The commission shall review a penalized provider within 10 working days after the provider notifies the Department of Aging and Disability Services that the deficiency that caused the imposition of the penalty has been corrected. If the commission is unable to review the provider within that 10-working-day period, the penalty ceases on the earlier of the last day of the minimum penalty period or the date the provider gives notice to the Department of Aging and Disability Services.
(f) Money collected as a result of the imposition of penalties may be used for the protection of the health or property of an individual whose personal property was lost due to a failure of a home or community care provider to meet the requirements for participation as a provider of home or community care.
Added by Acts 1993, 73rd Leg., ch. 132, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff. Sept. 1, 1995.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.078, eff. April 2, 2015.
Structure Texas Statutes
Title 2 - Human Services and Protective Services in General
Subtitle C - Assistance Programs
Chapter 32 - Medical Assistance Program
Subchapter B. Administrative Provisions
Section 32.021. Administration of the Program
Section 32.0212. Delivery of Medical Assistance
Section 32.0213. Nursing Facility Bed Certification and Decertification
Section 32.0214. Designations of Primary Care Provider by Certain Recipients
Section 32.0215. Home or Community Care Providers: Civil Monetary Penalties
Section 32.022. Medical and Hospital Care Advisory Committees
Section 32.023. Cooperation With Other State Agencies
Section 32.0231. Announcement of Funding or Program Change
Section 32.024. Authority and Scope of Program; Eligibility
Section 32.0241. Review of Waiver Request
Section 32.0242. Verification of Certain Information
Section 32.0244. Nursing Facility Beds in Certain Counties
Section 32.0245. Nursing Facility Beds for Certain Facilities Treating Alzheimer's Disease
Section 32.0249. Mental Health Screenings in Texas Health Steps Program
Section 32.025. Application for Medical Assistance
Section 32.0251. Eligibility Notification and Review for Certain Children
Section 32.0255. Transitional Medical Assistance
Section 32.0256. Continuation of Medical Assistance for Certain Individuals
Section 32.026. Certification of Eligibility and Need for Medical Assistance
Section 32.0261. Continuous Eligibility
Section 32.026101. Determination of Eligibility by Health Care Exchanges Prohibited
Section 32.02611. Exclusion of Assets in Prepaid Tuition Programs and Higher Education Savings Plans
Section 32.02613. Life Insurance Assets; Life Insurance Policy Conversion
Section 32.0262. Eligibility Transition
Section 32.0263. Health Care Orientation
Section 32.0264. Suspension and Reinstatement of Eligibility for Children in Juvenile Facilities
Section 32.0265. Notice of Certain Placements in Juvenile Facilities
Section 32.027. Selection of Provider of Medical Assistance
Section 32.028. Fees, Charges, and Rates
Section 32.0281. Rules and Notice Relating to Payment Rates
Section 32.0282. Public Hearing on Rates
Section 32.0284. Calculation of Payments Under Certain Supplemental Hospital Payment Programs
Section 32.029. Methods of Payment
Section 32.0291. Prepayment Reviews and Payment Holds
Section 32.031. Receipt and Expenditure of Funds
Section 32.0311. Drug Reimbursement Under Certain Programs
Section 32.0312. Reimbursement for Services Associated With Preventable Adverse Events
Section 32.0313. Induced Deliveries or Cesarean Sections Before 39th Week
Section 32.0314. Reimbursement for Durable Medical Equipment and Supplies
Section 32.0315. Funds for Graduate Medical Education
Section 32.0316. Electronic Transactions; Medicaid
Section 32.032. Prevention and Detection of Fraud and Abuse
Section 32.0322. Criminal History Record Information; Enrollment of Providers
Section 32.034. Contract Cancellation; Notice and Hearing
Section 32.036. Program Payments Nonassignable and Exempt From Legal Process
Section 32.038. Collection of Insurance Payments
Section 32.0381. Icf-Iid Payment Rates
Section 32.039. Damages and Penalties
Section 32.0391. Criminal Offense
Section 32.040. Identification of Husband or Alleged Father
Section 32.042. Information Required From Health Insurers
Section 32.0421. Administrative Penalty for Failure to Provide Information
Section 32.0423. Recovery of Reimbursements From Health Coverage Providers
Section 32.0424. Requirements of Third-Party Health Insurers
Section 32.04242. Payor of Last Resort
Section 32.0425. Reimbursement for Wheeled Mobility Systems
Section 32.043. Procurement Rules for Public Disproportionate Share Hospitals
Section 32.044. Group Purchasing for Disproportionate Share Hospitals
Section 32.045. Enhanced Reimbursement
Section 32.046. Sanctions and Penalties Related to the Provision of Pharmacy Products
Section 32.0461. Vendor Drug Program; Competitive Bidding
Section 32.0462. Vendor Drug Program; Pricing Standard
Section 32.0463. Medications and Medical Supplies
Section 32.047. Prohibition of Certain Health Care Service Providers
Section 32.048. Managed Care Information and Training Plan
Section 32.049. Managed Care Contract Compliance
Section 32.050. Dual Medicaid and Medicare Coverage
Section 32.051. Misdirected Billing
Section 32.052. Waiver Programs for Children With Disabilities or Special Health Care Needs
Section 32.0531. Pace Program Team
Section 32.0532. Pace Program Reimbursement Methodology
Section 32.0533. Data Collection: Pace and Star + Plus Medicaid Managed Care Programs
Section 32.054. Dental Services
Section 32.055. Catastrophic Case Management
Section 32.0551. Optimization of Case Management Systems
Section 32.056. Compliance With Texas Health Steps Comprehensive Care Program
Section 32.0561. Maternal Depression Screening
Section 32.057. Contracts for Disease Management Programs
Section 32.059. Use of Respiratory Therapists for Respiratory Therapy Services
Section 32.061. Community Attendant Services Program
Section 32.062. Admissibility of Certain Evidence Relating to Nursing Institutions
Section 32.063. Third-Party Billing Vendors
Section 32.067. Delivery of Comprehensive Care Services to Certain Recipients of Medical Assistance
Section 32.068. In-Person Evaluation Required for Certain Services
Section 32.069. Chronic Kidney Disease Management Initiative
Section 32.070. Audits of Providers
Section 32.0705. External Audits of Certain Medicaid Contractors Based on Risk
Section 32.071. Recipient and Provider Education
Section 32.072. Direct Access to Eye Health Care Services
Section 32.073. Health Information Technology Standards
Section 32.074. Access to Personal Emergency Response System
Section 32.075. Employment Assistance and Supported Employment