Tex. Ins. Code Section 845.153
Reimbursement at State-defined Capitation Rate

(a)

To the extent the system operates under a certificate of authority issued under Chapter 843 (Health Maintenance Organizations), the Medicaid contracting agency shall reimburse the system at the state-defined capitation rate for each service area in which the system operates.

(b)

The system is not required as a condition of participation in a state contract awarded under Section 845.151 (Contract Award) to accept from the Medicaid contracting agency a capitation rate that is lower than the state-defined capitation rate for each service area in which the system operates.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.

Source: Section 845.153 — Reimbursement at State-defined Capitation Rate, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.845.htm#845.153 (accessed May 18, 2024).

845.001
Short Title 845.002
Definitions 845.003
Rural Area Designation 845.004
Rules 845.051
Statewide Rural Health Care System 845.052
Organization Requirements 845.053
Requirements Applicable to Certain Plans 845.054
Local Government 845.055
Provision of Administrative and Health Care Services 845.056
Gifts and Grants 845.057
Limitation on Authority of Participating Hospital Providers 845.058
Sale or Dissolution of System 845.101
Appointment of Board 845.102
Terms 845.103
Removal of Certain Board Members 845.104
Board Duties 845.105
Rules Relating to Administrative and Health Care Services 845.106
Officers 845.107
Executive Committee 845.108
Administrative Services 845.109
Advisory Committees 845.110
Open Meetings and Records Requirements 845.151
Contract Award 845.152
Participation Requirement 845.153
Reimbursement at State-defined Capitation Rate 845.154
Right of State to Cancel Contract on Sale or Dissolution 845.155
Use of System as Pilot Program, Demonstration Project, or Study 845.201
Rural Health Care Delivery System 845.202
Patient Rights Policies 845.203
Patient-physician Relationship 845.204
Public Health and Prevention 845.205
Credentials and Peer Review 845.206
Quality Improvement and Management

Accessed:
May 18, 2024

§ 845.153’s source at texas.gov

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Location: https://texas.public.law/statutes/tex._ins._code_section_845.153

Original Source: Section 845.153 — Reimbursement at State-defined Capitation Rate, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.845.htm#845.153 (last accessed May 18, 2024).