Texas Health and Safety Code 108.0065 – Powers and Duties of Commission and Department Relating to Medicaid Managed Care
Current as of: 2024 | Check for updates
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Text of subsection effective until April 01, 2025
(a) In this section, “Medicaid managed care organization” means a managed care organization, as defined by § 533.001, Government Code, that is contracting with the commission to implement the Medicaid managed care program under Chapter 533, Government Code.
Text of subsection effective on April 01, 2025
Terms Used In Texas Health and Safety Code 108.0065
- Contract: A legal written agreement that becomes binding when signed.
(a) In this section, “Medicaid managed care organization” means a managed care organization, as defined by § 540.0001, Government Code, that is contracting with the commission to implement the Medicaid managed care program under Chapter 540 or 540A, 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, 108.011, 108.012, 108.013, 108.014, and 108.0141.
(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).