Body
Revision 06-1; Effective April 10, 2006
If you plan to assign your contract, you (the assignor) must notify the regional office in writing of the intent 60 days before assigning the contract. You and the assignee must complete Form 5881, Contract Assignment and Agreement, which includes information regarding:
- your and the assignee's authority to enter into the contract agreement; and
- any bankruptcy actions pending in court for you and the assignee.
Form 5881 must be notarized and include an original official notary seal. The Texas Health and Human Services Commission (HHSC) will use the information on the form to determine whether to approve a contract assignment. Failure to provide the form will result in the denial of the contract assignment. Submission of false information on the form will result in adverse action, up to and including denial of the contract assignment and/or termination of the assignor/assignee's contract. HHSC may also refer providers that submit false information for prosecution. The written notification from the assignor must be notarized and signed by the person authorized to sign the contract. Form 5881 must be mailed to the regional office.
The HHSC regional office mails a contract assignment application to the assignor within seven days after receipt of written notification to HHSC of the intent to assign a contract.
The guidelines for a contract assignment agreement are found in Appendix I, Assignment of Contracts, and Chapter 49, Contracting for Community Care Services.