2023 Texas Statutes › Human Resources Code › Title 2 - Human Services and Protective Services in General › Subtitle C - Assistance Programs › Chapter 36 - Health Care Program Fraud Prevention › Subchapter A. General Provisions › Section 36.005. Suspension or Revocation of Agreement; Professional Discipline

Sec. 36.005.  SUSPENSION OR REVOCATION OF AGREEMENT;  PROFESSIONAL DISCIPLINE.
Text of subsection effective until April 01, 2025
(a)  A health and human services agency, as defined by Section 531.001, Government Code:
(1)  shall suspend or revoke:
(A)  a provider agreement between the agency and a person, other than a person who operates a nursing facility or an ICF-IID, found liable under Section 36.052; and
(B)  a permit, license, or certification granted by the agency to a person, other than a person who operates a nursing facility or an ICF-IID, found liable under Section 36.052; and
(2)  may suspend or revoke:
(A)  a provider agreement between the agency and a person who operates a nursing facility or an ICF-IID and who is found liable under Section 36.052; or
(B)  a permit, license, or certification granted by the agency to a person who operates a nursing facility or an ICF-IID and who is found liable under Section 36.052.
Text of subsection effective on April 01, 2025
(a)  A health and human services agency, as defined by Section 521.0001, Government Code:
(1)  shall suspend or revoke:
(A)  a provider agreement between the agency and a person, other than a person who operates a nursing facility or an ICF-IID, found liable under Section 36.052; and
(B)  a permit, license, or certification granted by the agency to a person, other than a person who operates a nursing facility or an ICF-IID, found liable under Section 36.052; and
(2)  may suspend or revoke:
(A)  a provider agreement between the agency and a person who operates a nursing facility or an ICF-IID and who is found liable under Section 36.052; or
(B)  a permit, license, or certification granted by the agency to a person who operates a nursing facility or an ICF-IID and who is found liable under Section 36.052.
(b)  A provider found liable under Section 36.052 for an unlawful act may not, for a period of 10 years, provide or arrange to provide health care services under a health care program or supply or sell, directly or indirectly, a product to or under a health care program.  The executive commissioner may by rule:
(1)  provide for a period of ineligibility longer than 10 years; or
(2)  grant a provider a full or partial exemption from the period of ineligibility required by this subsection if the executive commissioner finds that enforcement of the full period of ineligibility is harmful to the program or a beneficiary of the program.
(b-1)  The period of ineligibility begins on the date on which the judgment finding the provider liable under Section 36.052 is entered by the trial court.
(b-2)  Subsections (b) and (b-1) do not apply to a provider who operates a nursing facility or an ICF-IID.
(c)  A person licensed by a state regulatory agency who commits an unlawful act is subject to professional discipline under the applicable licensing law or rules adopted under that law.
(d)  For purposes of this section, a person is considered to have been found liable under Section 36.052 if the person is found liable in an action brought under Subchapter C.
(e)  Notwithstanding Subsection (b-1), the period of ineligibility for an individual licensed by a health care regulatory agency or a physician begins on the date on which the determination that the individual or physician is liable becomes final.
(f)  For purposes of Subsection (e), a "physician" includes a physician, a professional association composed solely of physicians, a single legal entity authorized to practice medicine owned by two or more physicians, a nonprofit health corporation certified by the Texas Medical Board under Chapter 162, Occupations Code, or a partnership composed solely of physicians.
(g)  For purposes of Subsection (e), "health care regulatory agency" has the meaning assigned by Section 774.001, Government Code.
Added by Acts 1995, 74th Leg., ch. 824, Sec. 1, eff. Sept. 1, 1995.  Renumbered from Human Resources Code Sec. 36.009 by Acts 1997, 75th Leg., ch. 1153, Sec. 4.01(a), eff. Sept. 1, 1997.  Amended by Acts 1997, 75th Leg., ch. 1153, Sec. 4.06, eff. Sept. 1, 1997.
Amended by:
Acts 2005, 79th Leg., Ch. 806 (S.B. 563), Sec. 6, eff. September 1, 2005.
Acts 2013, 83rd Leg., R.S., Ch. 1311 (S.B. 8), Sec. 12, eff. September 1, 2013.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.182, eff. April 2, 2015.
Acts 2023, 88th Leg., R.S., Ch. 273 (S.B. 745), Sec. 6, eff. September 1, 2023.
Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 2.90, eff. April 1, 2025.