Tex. Gov't Code Section 542.0108
Managed Care Organization Participation Requirements


The commission shall require that a managed care organization participating in the pilot program:

(1)

ensures that pilot program participants have a choice among acute care and comprehensive long-term services and supports providers and service delivery options, including the consumer direction model;

(2)

demonstrates to the commission’s satisfaction that the organization’s network of acute care, long-term services and supports, and comprehensive long-term services and supports providers have experience and expertise in providing services for individuals with an intellectual or developmental disability and individuals with similar functional needs;

(3)

has a process for preventing the inappropriate institutionalization of pilot program participants; and

(4)

ensures the timely initiation and consistent provision of services in accordance with a pilot program participant’s person-centered plan.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.

Source: Section 542.0108 — Managed Care Organization Participation Requirements, https://statutes.­capitol.­texas.­gov/Docs/GV/htm/GV.­542.­htm#542.­0108 (accessed Jun. 5, 2024).

542.0001
Definitions
542.0002
Conflict with Other Law
542.0003
Delayed Implementation Authorized
542.0051
Redesign of Acute Care Services and Long-term Services and Supports System for Individuals with an Intellectual or Developmental Disability
542.0052
Intellectual and Developmental Disability System Redesign Advisory Committee
542.0053
Implementation of System Redesign
542.0054
Annual Report on Implementation
542.0101
Definitions
542.0102
Pilot Program to Test Person-centered Managed Care Strategies and Improvements Based on Capitation
542.0103
Alternative Payment Rate or Methodology
542.0104
Pilot Program Work Group
542.0105
Stakeholder Input
542.0106
Measurable Goals
542.0107
Managed Care Organization Selection
542.0108
Managed Care Organization Participation Requirements
542.0109
Required Benefits
542.0110
Provider Participation
542.0111
Care Coordination
542.0112
Person-centered Planning
542.0113
Use of Innovative Technology
542.0114
Informational Materials
542.0115
Implementation, Location, and Duration
542.0116
Recipient Enrollment, Participation, and Eligibility
542.0117
Pilot Program Information Collection and Analysis
542.0118
Pilot Program Conclusion
542.0119
Evaluations and Reports
542.0120
Transition Between Programs
542.0121
Service Transition Requirements
542.0151
Delivery of Acute Care Services to Individuals with an Intellectual or Developmental Disability
542.0201
Transition of Icf-iid Program Recipients and Certain Other Medicaid Waiver Program Recipients to Managed Care Program
542.0202
Recipient Choice of Delivery Model
542.0203
Required Contract Provisions
542.0204
Responsibilities of Commission Under Subchapter

Accessed:
Jun. 5, 2024

§ 542.0108’s source at texas​.gov