(a) In lieu of demanding payment of an administrative penalty assessed under Section 161.089, the commission may, in accordance with this section, allow the provider subject to the penalty to use, under the supervision of the commission, any portion of the amount of the penalty to ameliorate the violation or to improve services in the waiver program in which the provider participates.
(b) The commission shall offer amelioration to a provider under this section not later than the 10th day after the date the provider receives from the commission a final notification of the assessment of an administrative penalty that is sent to the provider after an informal dispute resolution process but before an administrative hearing.
Terms Used In Texas Human Resources Code 161.0891
- Rule: includes regulation. See Texas Government Code 311.005
(c) A provider to whom amelioration has been offered must file a plan for amelioration not later than the 45th day after the date the provider receives the offer of amelioration from the commission. In submitting the plan, the provider must agree to waive the provider’s right to an administrative hearing if the commission approves the plan.
(d) At a minimum, a plan for amelioration must:
(1) propose changes to the management or operation of the waiver program in which the provider participates that will improve services to or quality of care for recipients under the program;
(2) identify, through measurable outcomes, the ways in which and the extent to which the proposed changes will improve services to or quality of care for recipients under the waiver program;
(3) establish clear goals to be achieved through the proposed changes;
(4) establish a timeline for implementing the proposed changes; and
(5) identify specific actions necessary to implement the proposed changes.
(e) The commission may require that an amelioration plan propose changes that would result in conditions that exceed the requirements of a law or rule relating to the waiver program in which the provider participates.
(f) The commission shall approve or deny an amelioration plan not later than the 45th day after the date the commission receives the plan. On approval of a provider’s plan, the commission or the State Office of Administrative Hearings, as appropriate, shall deny a pending request for a hearing submitted by the provider.
(g) The commission may not offer amelioration to a provider:
(1) more than three times in a two-year period;
(2) more than one time in a two-year period for the same or similar violation; or
(3) for a violation that resulted in hazard to the health or safety of a recipient, including serious harm or death, or that substantially limits the provider’s ability to provide care.
(h) This section expires September 1, 2023.
For expiration of this section, see Subsection (h).