# 1 Tex. Admin. Code § 371.29: 1 TAC § 371.29. Random Prepayment Review

> Texas · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C371_S371_29

## Section

- **Citation:** 1 Tex. Admin. Code § 371.29
- **Heading:** 1 TAC § 371.29. Random Prepayment Review
- **Jurisdiction:** Texas
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Texas Administrative Code / Title 1 ADMINISTRATION / Part 15 TEXAS HEALTH AND HUMAN SERVICES COMMISSION / Chapter 371 MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY / 1 TAC § 371.29

## Text

The OIG may perform a random prepayment review of claims submitted
 by Medicaid providers for reimbursement to determine whether the claim
 involves fraud, waste, or abuse. Suspect claims identified through
 this process may result in:
(1) imposition of a recoupment of overpayments and/or
 other pertinent administrative sanctions or actions;
(2) initiation of a full fraud, waste, or abuse investigation;
(3) referral for criminal or civil investigation and
 prosecution;
(4) withholding payment of these claims for not more
 than five working days without notice to the provider for which claims
 were submitted.

## Nearby sections

- [1 Tex. Admin. Code § 371.1 1 TAC § 371.1. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C371_S371_1.md)
- [1 Tex. Admin. Code § 371.3 1 TAC § 371.3. Purpose and Authority](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C371_S371_3.md)
- [1 Tex. Admin. Code § 371.11 1 TAC § 371.11. Scope](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C371_S371_11.md)
- [1 Tex. Admin. Code § 371.17 1 TAC § 371.17. Detection](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C371_S371_17.md)
- [1 Tex. Admin. Code § 371.23 1 TAC § 371.23. Surety Bond](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C371_S371_23.md)
- [1 Tex. Admin. Code § 371.25 1 TAC § 371.25. Injunction to Prevent Disposing of Assets and Application to Debts](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C371_S371_25.md)
- [1 Tex. Admin. Code § 371.27 1 TAC § 371.27. Prohibition against Solicitation of Medicaid or CHIP Recipients](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C371_S371_27.md)
- [1 Tex. Admin. Code § 371.29 1 TAC § 371.29. Random Prepayment Review](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C371_S371_29.md)
- [1 Tex. Admin. Code § 371.31 1 TAC § 371.31. Federal Felony Match](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C371_S371_31.md)
- [1 Tex. Admin. Code § 371.33 1 TAC § 371.33. On-Site Reviews of Prospective Providers](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C371_S371_33.md)
- [1 Tex. Admin. Code § 371.35 1 TAC § 371.35. Use of Statistical Sampling and Extrapolation](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C371_S371_35.md)
- [1 Tex. Admin. Code § 371.37 1 TAC § 371.37. Audit of Managed Care Organizations](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C371_S371_37.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C371_S371_29. Check the current official text before relying on it. Not legal advice.