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December 2016 Texas Medicaid Provider Procedures Manual

Section 7: Appeals : 7.4 Cost Report Settlement Appeal Process : 7.4.1 Appeals to TMHP Medicaid Audit

7.4.1
A provider’s request to appeal his or her NPR must include the following:
The appeal may include any materials the provider believes will support its position.
TMHP Medicaid Audit completes a desk review of the appeal within six months of the date of receipt of complete documentation supporting the appeal. TMHP does the following:
Attempts to resolve as many points in controversy as possible with the provider and inform him or her in writing the issues that have been resolved and those that the provider may appeal to HHSC.
To appeal to TMHP Medicaid Audit, send the written notice within 120 days of receipt of the NPR letter to the following address:
Texas Medicaid & Healthcare Partnership
Medicaid Audit Operations Director
PO Box 200345
Austin, TX 78720‑0345

Texas Medicaid & Healthcare Partnership
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