TX HHS Form 2349. Second Level Appeal of Provider Investigation Finding

The TX HHS Form 2349, Second Level Appeal of Provider Investigation Finding, is a crucial document for healthcare providers seeking to challenge the findings of an investigation conducted by the Texas Health and Human Services (HHS) Provider Investigations program. This form allows providers to formally request an appeal of the investigation finding from the Director of HHSC PI.

To initiate the appeal process, providers must complete this form and provide a clear reason for their appeal request. The form requires providers to include their current address and phone number, as well as submit all relevant information that may not have been considered in the original investigation. This includes the final HHSC PI case report, exhibits, and video surveillance. Providers are responsible for ensuring that all required information is submitted, as failure to do so may delay the review of the investigation.

The appeal request must be sent to [email protected] or mailed to HHSC Provider Investigations Appeals at 14000 Summit Dr., Ste. 100, Mail Code: 0165, Austin, Texas 78728. Key points to note include:

• Providers must complete Form 2349 and provide a reason for their appeal request.
• The form requires providers to submit all relevant information, including the final HHSC PI case report and exhibits.
• The failure to send all required information may delay the review of the investigation.