1. (a) The trustee, acting through the TRS Executive Director, may expel from participation in the TRS-ActiveCare Program a participant who submits or causes to be submitted a false or fraudulent claim or enrollment application, or who has defrauded or attempted to defraud, any health benefits plan or pharmacy benefits plan offered under the program.
2. (b) Upon receipt of a complaint or upon its own motion, the TRS staff may file a petition for expulsion with the Executive Director. The Executive Director may docket the petition and refer the matter for a hearing by the State Office of Administrative Hearings.
3. (c) Following a hearing, the Executive Director may expel a person from participation in the program for a period of time not to exceed five years if the Executive Director finds that the person submitted or caused to be submitted a false or fraudulent claim or enrollment application or has defrauded or attempted to defraud any health benefits plan or pharmacy benefits plan offered under the program. Pursuant to the delegation of authority through this section, the order of the Executive Director is the final decision of TRS.

Source Note:The provisions of this §41.52 adopted to be effective December 26, 2002, 27 TexReg 12004.