Sec. 1355.057. REVIEW AND ADJUSTMENT OF MINIMUM RATIOS OF REIMBURSEMENT. (a) The commissioner shall monitor and review the minimum ratios of reimbursement for alternative treatments required by Sections 1355.055 and 1355.056.
(b) If the commissioner finds that the limits provided by this subchapter are creating an artificial increase in the costs of services, the commissioner by rule may adjust the ratios to the extent necessary to prevent the artificial increase.
(c) Before the commissioner adjusts a ratio under Subsection (b), the commissioner must give notice and hold a hearing to:
(1) consider information related to the adjustment; and
(2) determine whether the information justifies the adjustment.
(d) The department shall review the reimbursement ratios at least every two years.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle E - Benefits Payable Under Health Coverages
Chapter 1355 - Benefits for Certain Mental Disorders
Subchapter B. Alternative Mental Health Treatment Benefits
Section 1355.052. Applicability of Subchapter
Section 1355.053. Required Coverage for Certain Illnesses and Disorders
Section 1355.054. Conditions for Coverage
Section 1355.056. Determinations for Treatment by a Crisis Stabilization Unit
Section 1355.057. Review and Adjustment of Minimum Ratios of Reimbursement
Section 1355.058. Assistance of the Texas Department of Mental Health and Mental Retardation