Texas Statutes
Subtitle I - Health and Human Services
Chapter 536 - Medicaid and the Child Health Plan Program: Quality-Based Outcomes and Payments

Subchapter A. General Provisions

Section 536.001. Definitions - Sec. 536.001. DEFINITIONS. In this chapter: (1) Repealed by Acts...

Section 536.003. Development of Quality-Based Outcome and Process Measures - Sec. 536.003. DEVELOPMENT OF QUALITY-BASED OUTCOME AND PROCESS MEASURES. (a)...

Section 536.004. Development of Quality-Based Payment Systems - Sec. 536.004. DEVELOPMENT OF QUALITY-BASED PAYMENT SYSTEMS. (a) Using quality-based...

Section 536.005. Conversion of Payment Methodology - Sec. 536.005. CONVERSION OF PAYMENT METHODOLOGY. (a) To the extent...

Section 536.006. Transparency - Sec. 536.006. TRANSPARENCY. (a) The commission shall: (1) ensure transparency...

Section 536.007. Periodic Evaluation - Sec. 536.007. PERIODIC EVALUATION. (a) At least once each two-year...

Section 536.008. Annual Report - Sec. 536.008. ANNUAL REPORT. (a) The commission shall submit to...

Subchapter B. Quality-Based Payments Relating to Managed Care Organizations

Section 536.051. Development of Quality-Based Premium Payments; Performance Reporting - Sec. 536.051. DEVELOPMENT OF QUALITY-BASED PREMIUM PAYMENTS; PERFORMANCE REPORTING. (a)...

Section 536.052. Payment and Contract Award Incentives for Managed Care Organizations - Sec. 536.052. PAYMENT AND CONTRACT AWARD INCENTIVES FOR MANAGED CARE...

Subchapter C. Quality-Based Health Home Payment Systems

Section 536.101. Definitions - Sec. 536.101. DEFINITIONS. In this subchapter: (1) "Health home" means...

Section 536.102. Quality-Based Health Home Payments - Sec. 536.102. QUALITY-BASED HEALTH HOME PAYMENTS. (a) Subject to this...

Section 536.103. Provider Eligibility - Sec. 536.103. PROVIDER ELIGIBILITY. To be eligible to receive reimbursement...

Subchapter D. Quality-Based Hospital Reimbursement System

Section 536.151. Collection and Reporting of Certain Information - Sec. 536.151. COLLECTION AND REPORTING OF CERTAIN INFORMATION. (a) The...

Section 536.152. Reimbursement Adjustments - Sec. 536.152. REIMBURSEMENT ADJUSTMENTS. (a) Subject to Subsection (b), using...

Subchapter E. Quality-Based Payment Initiatives

Section 536.201. Definition - Sec. 536.201. DEFINITION. In this subchapter, "payment initiative" means a...

Section 536.202. Payment Initiatives; Determination of Benefit to State - Sec. 536.202. PAYMENT INITIATIVES; DETERMINATION OF BENEFIT TO STATE. (a)...

Section 536.203. Purpose and Implementation of Payment Initiatives - Sec. 536.203. PURPOSE AND IMPLEMENTATION OF PAYMENT INITIATIVES. (a) If...

Section 536.204. Standards; Protocols - Sec. 536.204. STANDARDS; PROTOCOLS. (a) The executive commissioner shall develop...

Section 536.205. Payment Rates Under Payment Initiatives - Sec. 536.205. PAYMENT RATES UNDER PAYMENT INITIATIVES. The executive commissioner...

Subchapter F. Quality-Based Long-Term Services and Supports Payment Systems

Section 536.251. Quality-Based Long-Term Services and Supports Payments - Sec. 536.251. QUALITY-BASED LONG-TERM SERVICES AND SUPPORTS PAYMENTS. (a) Subject...

Section 536.252. Evaluation of Data Sets - Sec. 536.252. EVALUATION OF DATA SETS. To ensure that the...

Section 536.253. Collection and Reporting of Certain Information - Sec. 536.253. COLLECTION AND REPORTING OF CERTAIN INFORMATION. (a) The...