Tex.
Health & Safety Code Section 108.0065
Powers and Duties of Commission and Department Relating to Medicaid Managed Care
(a)
In this section, “Medicaid managed care organization” means a managed care organization, as defined by Section 533.001 (Definitions), Government Code, that is contracting with the commission to implement the Medicaid managed care program under Chapter 533, Government Code.(a)
In this section, “Medicaid managed care organization” means a managed care organization, as defined by Section 540.0001 (Definitions), Government Code, that is contracting with the commission to implement the Medicaid managed care program under Chapter 540 (Medicaid Managed Care Program) or 540A (Medicaid Managed Transportation Services), Government Code, as applicable.(b)
The commission may direct the department to collect data under this chapter with respect to Medicaid managed care organizations. The department shall coordinate the collection of the data with the collection of data for health benefit plan providers, but with the approval of the commission may collect data in addition to the data otherwise required of health benefit plan providers.(c)
Each Medicaid managed care organization shall provide to the department the data required by the executive commissioner in the form required by the executive commissioner or, if the data is also being submitted to the commission, in the form required by the commission.(d)
Dissemination of data collected under this section is subject to Sections 108.010 (Collection and Dissemination of Provider Quality Data), 108.011 (Dissemination of Public Use Data and Department Publications), 108.012 (Computer Access to Data), 108.013 (Confidentiality and General Access to Data), 108.014 (Civil Penalty), and 108.0141 (Criminal Penalty).(e)
The commission shall analyze the data collected in accordance with this section and shall use the data to:(1)
evaluate the effectiveness and efficiency of the Medicaid managed care system;(2)
determine the extent to which Medicaid managed care does or does not serve the needs of Medicaid recipients in this state; and(3)
assess the cost-effectiveness of the Medicaid managed care system in comparison to the fee-for-service system, considering any improvement in the quality of care provided.(h)
The commission, using existing funds, may contract with an entity to comply with the requirements under Subsection (e).
Source:
Section 108.0065 — Powers and Duties of Commission and Department Relating to Medicaid Managed Care, https://statutes.capitol.texas.gov/Docs/HS/htm/HS.108.htm#108.0065 (accessed Jun. 5, 2024).
