1. (a) For an applicant or provider assigned a screening level of "Limited," HHSC-OIG verifies the accuracy and completeness of the information in or related to the enrollment application, information about the applicant contained in state or federal records, including criminal history records, and any additional information requested of the applicant by HHSC-OIG.

2. (b) For an applicant assigned a screening level of "Moderate," HHSC-OIG:

   1. (1) verifies all items described in subsection (a) of this section; and
   2. (2) performs at least one unscheduled and unannounced pre- and post-enrollment site visit, as described in subsection (d) of this section and in accordance with §352.9 of this title (relating to Screening Levels), if applicable, as described in subsection (d) of this section.

3. (c) For an applicant or provider assigned a screening level of "High," HHSC or HHSC-OIG performs:

   1. (1) all the verifications described in subsections (a) and (b) of this section; and
   2. (2) a fingerprint-based criminal history check, in the form and manner prescribed by state or federal law, of each person that is an individual and has an ownership or control interest as defined in §371.1005 of this subchapter (relating to Disclosure Requirements) in the applicant.
4. (d) An unscheduled and unannounced pre- or post-enrollment site visit conducted in accordance with subsections (b) and (c) of this section verifies compliance with state and federal law, rule, and policy governing the Medicaid and CHIP programs. Documents compiled, subpoenaed, or maintained by the HHSC-OIG in connection with a site visit are confidential pursuant to Texas Government Code §531.1021(g) and (h).
5. (e) HHSC-OIG, in its sole discretion, may accept previously submitted fingerprints if an individual has been subjected to a fingerprint-based criminal history check by a licensing or regulatory authority or by another state's Medicaid, CHIP, or medical assistance program and the results are made available to HHSC.

Source Note:The provisions of this §371.1009 adopted to be effective December 31, 2012, 37 TexReg 10189.