Sec. 845.153. REIMBURSEMENT AT STATE-DEFINED CAPITATION RATE. (a) To the extent the system operates under a certificate of authority issued under Chapter 843, 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 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.
Structure Texas Statutes
Title 6 - Organization of Insurers and Related Entities
Subtitle C - Life, Health, and Accident Insurers and Related Entities
Chapter 845 - Statewide Rural Health Care System
Subchapter D. State Managed Care Contracts
Section 845.151. Contract Award
Section 845.152. Participation Requirement
Section 845.153. Reimbursement at State-Defined Capitation Rate
Section 845.154. Right of State to Cancel Contract on Sale or Dissolution
Section 845.155. Use of System as Pilot Program, Demonstration Project, or Study