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Texas Health and Human Services Commission (HHSC) prohibits solicitation.
Texas Occupations Code, Chapter 102 prohibits a person from securing or soliciting business or patients for, or from, an individual or entity licensed, certified or registered by a state health care regulatory agency under certain circumstances. An alleged violation of Chapter 102 is prosecuted by the Texas Attorney General or the appropriate county or district attorney, as provided by §102.009 and §102.010. Texas Government Code §531.02115 prohibits a Medicaid provider from engaging in certain marketing activities that are intended to influence a person’s choice of provider. HHSC’s rule at 1 Texas Administrative Code (TAC) §354.1452, Provider Marketing, describes prohibited and permissible marketing activities under §531.02115.
HHSC’s rule at TAC, Title 1, §371.27, Prohibition against Solicitation of Medicaid or CHIP Recipients, requires a Medicaid provider to comply with Chapter 102. If a Medicaid provider violates Chapter 102, the rule allows for termination of the contract of the provider and exclusion of the provider from participation in the Medicaid program.
Complaints Regarding Solicitation
A complaint alleging that a person has violated Texas Occupations Code Chapter 102, Solicitation of Patients, or Texas Government Code §531.02115, Marketing Activities by Providers Participating in Medicaid or Child Health Plan Program, will be investigated by HHSC’s Office of Inspector General (OIG).
If you have reason to believe that Chapter 102 or §531.02115 has been violated, report the alleged violation to the OIG at the following address:
Texas Health and Human Services Commission
Office of Inspector General
Chief Counsel’s Office
P.O. Box 85200, Mail Code I-1350
Austin, Texas 78708
You may also report the allegation to the OIG by telephone, toll-free, at 800-436-6184 or online at https://oig.hhsc.texas.gov/report-fraud.
This appendix appears in the following handbooks:
Community Living Assistance and Support Services Provider Manual (CLASS): Appendix XIV
Consumer Directed Services Handbook (CDS): Appendix III
Contracting to Provide Primary Home Care Services Handbook (CPPHCS): Appendix VI
Day Activity and Health Services Provider Manual (DAHS): Appendix VI
Deaf Blind with Multiple Disabilities Program Manual (DBMD): Appendix X
Home and Community-based Services Handbook (HCS): Appendix XI
Local Intellectual and Developmental Disability Authority Handbook (LIDDA): Appendix III
Medicaid Hospice Provider Manual (MHPM): Appendix IX
Texas Home Living Program Handbook (TxHmL): Appendix VIII