Tex.
Gov't Code Section 531.0211
Managed Care Medicaid Program: Rules; Education Programs
(a)
In adopting rules to implement a managed care Medicaid program, the executive commissioner shall establish guidelines for, and require managed care organizations to provide, education programs for providers and clients using a variety of techniques and mediums.(b)
A provider education program must include information on:(1)
Medicaid policies, procedures, eligibility standards, and benefits;(2)
the specific problems and needs of Medicaid clients; and(3)
the rights and responsibilities of Medicaid clients under the bill of rights and the bill of responsibilities prescribed by Section 531.0212 (Medicaid Bill of Rights and Bill of Responsibilities).(c)
A client education program must present information in a manner that is easy to understand. A program must include information on:(1)
a client’s rights and responsibilities under the bill of rights and the bill of responsibilities prescribed by Section 531.0212 (Medicaid Bill of Rights and Bill of Responsibilities);(2)
how to access health care services;(3)
how to access complaint procedures and the client’s right to bypass the managed care organization’s internal complaint system and use the notice and appeal procedures otherwise required by Medicaid;(4)
Medicaid policies, procedures, eligibility standards, and benefits;(5)
the policies and procedures of the managed care organization; and(6)
the importance of prevention, early intervention, and appropriate use of services.
Source:
Section 531.0211 — Managed Care Medicaid Program: Rules; Education Programs, https://statutes.capitol.texas.gov/Docs/GV/htm/GV.531.htm#531.0211 (accessed May 26, 2025).
