TX HHS Form H1095. Treatment Facility Fraud Referral

The TX HHS Form H1095, Treatment Facility Fraud Referral, is a crucial tool for identifying and reporting suspected fraud in treatment facilities that receive Supplemental Nutrition Assistance Program (SNAP) benefits. This form helps to streamline the process of reporting fraudulent activities, ensuring that any discrepancies are promptly addressed and resolved.

The form requires essential information from the treatment facility, including the facility's name, address, and contact details. It also asks for the basis of suspected fraud, such as accessing SNAP benefits after a client has left or accessing more than half of the benefits before the 16th of the month. The form must be completed by the treatment facility and submitted to the Office of Inspector General (OIG) at HHSC OIG Policy.

By using this form, treatment facilities can help prevent fraud and ensure that SNAP benefits are used appropriately. Key features include providing a clear reason for suspected fraud, reporting the total amount owed to HHSC, and obtaining a signature from the facility representative. The following key points summarize the use of this form:

• The form is used by treatment facilities to report suspected fraud in accessing SNAP benefits.
• It requires essential information about the facility and the basis of suspected fraud.
• The form must be completed and submitted to the OIG at HHSC OIG Policy.