Last September 27th, TDMR published an article concerning the fact that the Texas Health and Human Services Commission Office of the Inspector General at that time had not yet made available on its website, information on due process rights for Medicaid providers that had been mandated by SB1803 which came into effect September 1st.
TDMR as a result published its own FAQ on the due process rights made available under the legislation.
A recent glance at the OIG website found that some information has now been posted by OIG to delineate the due process rights of providers and come into some kind of compliance with SB1803. It is not known when this was posted. It certainly was not promoted in the HHSC In Touch newsletter in the last three editions.
Specifically, there are now three one-page PDF files that providers can download that show in an flow chart style, the following:
Costs for State Office of Administrative Hearings
Recoupment of Overpayment
Payment Hold
However, the legislation states:
“The commission’s office of inspector general shall post on its publicly available website a description in plain English of, and a video explaining, the processes and procedures the office uses to determine whether to impose a payment hold on a provider under this subchapter.”
There is still no information on the “processes and procedures the office uses to determine whether to impose a payment hold.”
Considering the importance of these rights to providers, the effort to inform is poor. It is hoped that in the near future more information will be made available by the agency and that it is broadly promoted so that providers are informed.