TX HHS Form 2940. Request for an Administrative Review

The TX HHS Form 2940, Request for an Administrative Review, is a crucial document that helps individuals or organizations dispute decisions or actions made by the Texas Health and Human Services Commission (HHSC). This form should be used when seeking an informal evaluation to determine if a decision or action was appropriate.

To initiate the review process, users must provide required information in three sections. Section 1, Operations Information, requires the name of the operation, area code, and phone number. In Section 2, Requestor's Information, users must identify themselves as the requestor, providing their name, area code, and phone number. This section is crucial when the HHSC decision or action relates to an individual or organization.

Section 3, HHSC's Decision or Action, is where users describe the decision or action being disputed, including the date of notification and any supporting documentation. Users must explain why they are disputing the decision or action, providing reasons why it should not be upheld. This section is critical in presenting a clear case for an administrative review.