Section 544.0052 - [Effective 4/1/2025] Rules Regarding Enforcement And Punitive Actions(a) The executive commissioner, in consultation with the office of inspector general, shall adopt rules establishing criteria for determining enforcement and punitive actions regarding a provider who violated state law, program rules, or the provider's Medicaid provider agreement.(b) The rules must include:(1) direction for categorizing provider violations according to the nature of the violation and for scaling resulting enforcement actions, taking into consideration:(A) the seriousness of the violation;(B) the prevalence of errors by the provider;(C) the financial or other harm to this state or recipients resulting or potentially resulting from those errors; and(D) mitigating factors the office of inspector general determines appropriate; and(2) a specific list of potential penalties, including the amount of the penalties, for fraud and other Medicaid violations. (Gov. Code, Sec. 531.102(x).)Tex. Gov't. Code § 544.0052
Added by Acts 2023, Texas Acts of the 88th Leg.- Regular Session, ch. 769,Sec. 1.01, eff. 4/1/2025.