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 an investigation finding from the Texas Health and Human Services (HHS) Provider Investigations program. This form enables providers to formally request an appeal of an investigation finding from the Director of HHSC PI.

To use this form effectively, providers must complete it thoroughly, including their reason for appealing the investigation finding, as well as their current address and phone number for any potential contact from the PI team. The applicable rules governing this process can be found in Title 26 of the Texas Administrative Code, Chapter 711, Subchapter J.

The form requires providers to submit a completed Form 2349, the final HHSC PI case report including exhibits and video surveillance, as well as any relevant information that may not have been considered during the investigation. The failure to provide all required documents may delay the review of the investigation finding. This form should be used when seeking a second-level appeal of an investigation finding from the Provider Investigations program.