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RULE §371.1013 Provider Enrollment Recommendations

Published: 2015

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(a) HHSC-OIG makes a recommendation on each enrollment
application submitted for review in accordance with the requirements
of this subchapter (relating to Provider Disclosure and Screening)
and Chapter 352 of this title (relating to Medicaid and Children's
Health Insurance Program Provider Enrollment), or other rule, as applicable.
The recommendation is at the sole discretion of HHSC-OIG, and is not
subject to administrative review or reconsideration.
(b) In making its enrollment recommendation, HHSC-OIG
may consider any relevant circumstance or factor as it applies to
the applicant, provider, or any person required to be disclosed in
the enrollment application in accordance with this subchapter and
Chapter 352 of this title, if applicable.
(c) Upon making a recommendation on a complete application,
HHSC-OIG informs HHSC of its recommendation. HHSC makes the final
enrollment decision after considering:
  (1) HHSC-OIG's recommendation;
  (2) any conditions for approval recommended by HHSC-OIG;
  (3) the availability of access to care; and
  (4) any other relevant facts or circumstances.

Source Note: The provisions of this §371.1013 adopted to be effective December 31, 2012, 37 TexReg 10189; amended to be effective October 1, 2015, 40 TexReg 6585