Open For Public Comment: New SHARS Policies

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HHSC New SHARS Policy is posted here for Public Comment

SHARS providers must maintain and retain all necessary records  needed to provide full disclosure regarding services and supplies. These records must be made available to employees, agents, or contractors of HHSC OIG, the Office of the Attorney General (OAG) Medicaid Fraud Control Unit (MFCU) or Antitrust and Civil Medicaid Fraud Section, TMHP, DFPS, HHSC, DSHS, Texas Workforce Commission (TWC), U.S. Department of Health and Human Services (HHS) representative, and any state or federal agency authorized to conduct compliance,  regulatory, or program integrity reviews. 
At the time of the request, the SHARS provider must allow immediate access to the premises and records for purposes of reviewing and securing custody of records, documents, electronic data, equipment, or other requested items, as determined necessary by the requestor.
The SHARS provider is required to submit original documents, records, and accompanying business records. At the discretion of the requestor, the provider may be permitted to provide copies notarized with the required business records affidavit. Requested records must be provided promptly and at no cost to the state or federal agency.
If the requestor suspects items may be altered or destroyed, the documents must be provided at the time of the request or in less than 24 hours as allowed by the requestor.
Failure to supply the requested documents within the time frame specified, may result in
  • a withholding of Medicaid payments,   
  • recoupment of payments for all claims related to the missing records, 
  • contract cancellation, and/or
  • exclusion from Texas Medicaid.
 
Texas Medicaid Provider Procedures Manual, Provider Enrollment and Responsibilities,    December 2020 (1.7.3)1 TAC §371.1667.