Texas Statutes
Title 4 - Executive Branch
Subtitle I - Health and Human Services

Section 533.013. Premium Payment Rate Determination; Review and Comment - Sec. 533.013. PREMIUM PAYMENT RATE DETERMINATION; REVIEW AND COMMENT. (a)...

Section 533.0131. Use of Encounter Data in Determining Premium Payment Rates - Sec. 533.0131. USE OF ENCOUNTER DATA IN DETERMINING PREMIUM PAYMENT...

Section 533.01315. Reimbursement for Services Provided Outside of Regular Business Hours - Sec. 533.01315. REIMBURSEMENT FOR SERVICES PROVIDED OUTSIDE OF REGULAR BUSINESS...

Section 533.0132. State Taxes - Sec. 533.0132. STATE TAXES. The commission shall ensure that any...

Section 533.014. Profit Sharing - Sec. 533.014. PROFIT SHARING. (a) The executive commissioner shall adopt...

Section 533.015. Coordination of External Oversight Activities - Sec. 533.015. COORDINATION OF EXTERNAL OVERSIGHT ACTIVITIES. (a) To the...

Section 533.016. Provider Reporting of Encounter Data - Sec. 533.016. PROVIDER REPORTING OF ENCOUNTER DATA. The commission shall...

Section 533.0161. Monitoring of Psychotropic Drug Prescriptions for Certain Children - Sec. 533.0161. MONITORING OF PSYCHOTROPIC DRUG PRESCRIPTIONS FOR CERTAIN CHILDREN....

Section 533.017. Qualifications of Certifier of Encounter Data - Sec. 533.017. QUALIFICATIONS OF CERTIFIER OF ENCOUNTER DATA. (a) The...

Section 533.018. Certification of Encounter Data - Sec. 533.018. CERTIFICATION OF ENCOUNTER DATA. (a) The certifier of...

Section 533.019. Value-Added Services - Sec. 533.019. VALUE-ADDED SERVICES. The commission shall actively encourage managed...

Section 533.020. Managed Care Organizations: Fiscal Solvency and Complaint System Guidelines - Sec. 533.020. MANAGED CARE ORGANIZATIONS: FISCAL SOLVENCY AND COMPLAINT SYSTEM...

Section 533.038. Coordination of Benefits; Continuity of Specialty Care for Certain Recipients - Sec. 533.038. COORDINATION OF BENEFITS; CONTINUITY OF SPECIALTY CARE FOR...

Section 533.039. Delivery of Benefits Using Telecommunications and Information Technology - Sec. 533.039. DELIVERY OF BENEFITS USING TELECOMMUNICATIONS AND INFORMATION TECHNOLOGY....

Subchapter B. Strategy for Managing Audit Resources

Section 533.051. Definitions - Sec. 533.051. DEFINITIONS. In this subchapter: (1) "Accounts receivable tracking...

Section 533.052. Applicability and Construction of Subchapter - Sec. 533.052. APPLICABILITY AND CONSTRUCTION OF SUBCHAPTER. This subchapter does...

Section 533.053. Overall Strategy for Managing Audit Resources - Sec. 533.053. OVERALL STRATEGY FOR MANAGING AUDIT RESOURCES. The commission...

Section 533.054. Performance Audit Selection Process and Follow-Up - Sec. 533.054. PERFORMANCE AUDIT SELECTION PROCESS AND FOLLOW-UP. (a) To...

Section 533.055. Agreed-Upon Procedures Engagements and Corrective Action Plans - Sec. 533.055. AGREED-UPON PROCEDURES ENGAGEMENTS AND CORRECTIVE ACTION PLANS. To...

Section 533.056. Audits of Pharmacy Benefit Managers - Sec. 533.056. AUDITS OF PHARMACY BENEFIT MANAGERS. To obtain greater...

Section 533.057. Collection of Costs for Audit-Related Services - Sec. 533.057. COLLECTION OF COSTS FOR AUDIT-RELATED SERVICES. The commission...

Section 533.058. Collection Activities Related to Profit Sharing - Sec. 533.058. COLLECTION ACTIVITIES RELATED TO PROFIT SHARING. To strengthen...

Section 533.059. Use of Information From External Quality Reviews - Sec. 533.059. USE OF INFORMATION FROM EXTERNAL QUALITY REVIEWS. (a)...

Section 533.060. Security and Processing Controls Over Information Technology Systems - Sec. 533.060. SECURITY AND PROCESSING CONTROLS OVER INFORMATION TECHNOLOGY SYSTEMS....

Subchapter E. Pilot Program to Increase Incentive-Based Provider Payments

Section 533.083. Assessment and Implementation of Pilot Program Findings - Sec. 533.083. ASSESSMENT AND IMPLEMENTATION OF PILOT PROGRAM FINDINGS. Not...

Chapter 534 - System Redesign for Delivery of Medicaid Acute Care Services and Long-Term Services and Supports to Persons With an Intellectual or Developmental Disability

Subchapter A. General Provisions

Section 534.001. Definitions - Sec. 534.001. DEFINITIONS. In this chapter: (1) "Advisory committee" means...

Section 534.002. Conflict With Other Law - Sec. 534.002. CONFLICT WITH OTHER LAW. To the extent of...

Subchapter B. Acute Care Services and Long-Term Services and Supports System

Section 534.051. Acute Care Services and Long-Term Services and Supports System for Individuals With an Intellectual or Developmental Disability - Sec. 534.051. ACUTE CARE SERVICES AND LONG-TERM SERVICES AND SUPPORTS...

Section 534.052. Implementation of System Redesign - Sec. 534.052. IMPLEMENTATION OF SYSTEM REDESIGN. The commission shall, in...

Section 534.053. Intellectual and Developmental Disability System Redesign Advisory Committee - Sec. 534.053. INTELLECTUAL AND DEVELOPMENTAL DISABILITY SYSTEM REDESIGN ADVISORY COMMITTEE....

Section 534.054. Annual Report on Implementation - Sec. 534.054. ANNUAL REPORT ON IMPLEMENTATION. (a) Not later than...

Subchapter C. Stage One: Pilot Program for Improving Service Delivery Models

Section 534.101. Definitions - Sec. 534.101. DEFINITIONS. In this subchapter: (1) "Capitation" means a...

Section 534.1015. Pilot Program Workgroup - Sec. 534.1015. PILOT PROGRAM WORKGROUP. (a) The executive commissioner, in...

Section 534.102. Pilot Program to Test Person-Centered Managed Care Strategies and Improvements Based on Capitation - Sec. 534.102. PILOT PROGRAM TO TEST PERSON-CENTERED MANAGED CARE STRATEGIES...

Section 534.103. Stakeholder Input - Sec. 534.103. STAKEHOLDER INPUT. As part of developing and implementing...

Section 534.1035. Managed Care Organization Selection - Sec. 534.1035. MANAGED CARE ORGANIZATION SELECTION. (a) The commission, in...

Section 534.104. Pilot Program Design - Sec. 534.104. PILOT PROGRAM DESIGN. (a) The pilot program must...

Section 534.1045. Pilot Program Benefits and Provider Qualifications - Sec. 534.1045. PILOT PROGRAM BENEFITS AND PROVIDER QUALIFICATIONS. (a) Subject...

Section 534.105. Pilot Program: Measurable Goals - Sec. 534.105. PILOT PROGRAM: MEASURABLE GOALS. (a) The commission, in...

Section 534.106. Implementation, Location, and Duration - Sec. 534.106. IMPLEMENTATION, LOCATION, AND DURATION. (a) The commission shall...

Section 534.1065. Recipient Enrollment, Participation, and Eligibility - Sec. 534.1065. RECIPIENT ENROLLMENT, PARTICIPATION, AND ELIGIBILITY. (a) An individual...

Section 534.107. Commission Responsibilities - Sec. 534.107. COMMISSION RESPONSIBILITIES. (a) The commission shall require that...

Section 534.108. Pilot Program Information - Sec. 534.108. PILOT PROGRAM INFORMATION. (a) The commission, in consultation...

Section 534.109. Person-Centered Planning - Sec. 534.109. PERSON-CENTERED PLANNING. The commission, in consultation and collaboration...

Section 534.110. Transition Between Programs; Continuity of Services - Sec. 534.110. TRANSITION BETWEEN PROGRAMS; CONTINUITY OF SERVICES. (a) During...

Section 534.111. Conclusion of Pilot Program - Sec. 534.111. CONCLUSION OF PILOT PROGRAM. (a) On September 1,...

Section 534.112. Pilot Program Evaluations and Reports - Sec. 534.112. PILOT PROGRAM EVALUATIONS AND REPORTS. (a) The commission,...

Subchapter D. Stage One: Provision of Acute Care and Certain Other Services

Section 534.151. Delivery of Acute Care Services for Individuals With an Intellectual or Developmental Disability - Sec. 534.151. DELIVERY OF ACUTE CARE SERVICES FOR INDIVIDUALS WITH...

Section 534.152. Delivery of Certain Other Services Under Star + Plus Medicaid Managed Care Program and by Waiver Program Providers - Sec. 534.152. DELIVERY OF CERTAIN OTHER SERVICES UNDER STAR +...

Subchapter E. Stage Two: Transition of Icf-Iid Program Recipients and Long-Term Care Medicaid Waiver Program Recipients to Integrated Managed Care System

Section 534.202. Determination to Transition Icf-Iid Program Recipients and Certain Other Medicaid Waiver Program Recipients to Managed Care Program - Sec. 534.202. DETERMINATION TO TRANSITION ICF-IID PROGRAM RECIPIENTS AND CERTAIN...

Section 534.203. Responsibilities of Commission Under Subchapter - Sec. 534.203. RESPONSIBILITIES OF COMMISSION UNDER SUBCHAPTER. In administering this...

Subchapter F. Other Implementation Requirements and Responsibilities

Section 534.251. Delayed Implementation Authorized - Sec. 534.251. DELAYED IMPLEMENTATION AUTHORIZED. Notwithstanding any other law, the...

Section 534.252. Requirements Regarding Transition of Services - Sec. 534.252. REQUIREMENTS REGARDING TRANSITION OF SERVICES. (a) For purposes...

Chapter 535 - Provision of Human Services and Other Social Services Through Faith- and Community-Based Organizations

Subchapter A. General Provisions

Section 535.001. Definitions - Sec. 535.001. DEFINITIONS. In this chapter: (1) "Community-based initiative" includes...

Section 535.002. Purpose - Sec. 535.002. PURPOSE. The purpose of this chapter is to...

Section 535.003. Construction - Sec. 535.003. CONSTRUCTION. This chapter may not be construed to:...

Section 535.004. Applicability of Certain Federal Law - Sec. 535.004. APPLICABILITY OF CERTAIN FEDERAL LAW. A power authorized...

Subchapter B. Governmental Liaisons for Faith- And

Section 535.051. Designation of Faith- and Community-Based Liaisons - Sec. 535.051. DESIGNATION OF FAITH- AND COMMUNITY-BASED LIAISONS. (a) The...

Section 535.052. General Duties of Liaisons - Sec. 535.052. GENERAL DUTIES OF LIAISONS. (a) A faith- and...

Section 535.053. Interagency Coordinating Group - Sec. 535.053. INTERAGENCY COORDINATING GROUP. (a) The interagency coordinating group...

Section 535.054. Report - Sec. 535.054. REPORT. (a) Not later than December 1 of...

Section 535.055. Texas Nonprofit Council - Sec. 535.055. TEXAS NONPROFIT COUNCIL. (a) The Texas Nonprofit Council...

Subchapter C. Renewing Our Communities Account

Section 535.101. Definition - Sec. 535.101. DEFINITION. In this subchapter, "account" means the renewing...

Section 535.102. Purposes of Subchapter - Sec. 535.102. PURPOSES OF SUBCHAPTER. Recognizing that faith- and community-based...

Section 535.103. Renewing Our Communities Account - Sec. 535.103. RENEWING OUR COMMUNITIES ACCOUNT. (a) The renewing our...

Section 535.104. Powers and Duties Regarding Account - Sec. 535.104. POWERS AND DUTIES REGARDING ACCOUNT. (a) The commission...

Section 535.105. Administration of Account Funds - Sec. 535.105. ADMINISTRATION OF ACCOUNT FUNDS. If under Section 535.104...

Section 535.106. Reports and Public Information - Sec. 535.106. REPORTS AND PUBLIC INFORMATION. (a) The commission shall...

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...

Chapter 537 - Medicaid Reform Waiver

Section 537.002. Federal Authorization for Medicaid Reform - Sec. 537.002. FEDERAL AUTHORIZATION FOR MEDICAID REFORM. (a) The executive...

Chapter 538 - Medicaid Quality Improvement Process for Clinical Initiatives

Subchapter A. General Provisions

Section 538.002. Effect of Chapter; Authority of Commission - Sec. 538.002. EFFECT OF CHAPTER; AUTHORITY OF COMMISSION. This chapter...

Section 538.003. Rules - Sec. 538.003. RULES. The executive commissioner shall adopt rules necessary...

Subchapter B. Medicaid Quality Improvement Process to Assess Certain Clinical Initiatives

Section 538.051. Medicaid Quality Improvement Process - Sec. 538.051. MEDICAID QUALITY IMPROVEMENT PROCESS. The commission shall, according...

Section 538.052. Solicitation of Suggestions for Clinical Initiatives - Sec. 538.052. SOLICITATION OF SUGGESTIONS FOR CLINICAL INITIATIVES. (a) Subject...

Section 538.053. Clinical Initiative Evaluation Process - Sec. 538.053. CLINICAL INITIATIVE EVALUATION PROCESS. The commission shall establish...

Section 538.054. Analysis of Clinical Initiatives - Sec. 538.054. ANALYSIS OF CLINICAL INITIATIVES. The commission shall conduct...

Section 538.055. Final Report on Clinical Initiative - Sec. 538.055. FINAL REPORT ON CLINICAL INITIATIVE. The commission shall...

Section 538.056. Internet Website - Sec. 538.056. INTERNET WEBSITE. The commission shall maintain an Internet...

Section 538.057. Action on Clinical Initiative by Commission - Sec. 538.057. ACTION ON CLINICAL INITIATIVE BY COMMISSION. After the...

Chapter 539 - Community Collaboratives

Section 539.001. Definition - Sec. 539.001. DEFINITION. In this chapter, "department" means the Department...

Section 539.002. Grants for Establishment and Expansion of Community Collaboratives - Sec. 539.002. GRANTS FOR ESTABLISHMENT AND EXPANSION OF COMMUNITY COLLABORATIVES....

Section 539.003. Acceptable Uses of Grant Money - Sec. 539.003. ACCEPTABLE USES OF GRANT MONEY. An entity shall...

Section 539.004. Elements of Community Collaboratives - Sec. 539.004. ELEMENTS OF COMMUNITY COLLABORATIVES. (a) If appropriate, an...

Section 539.005. Outcome Measures for Community Collaboratives - Sec. 539.005. OUTCOME MEASURES FOR COMMUNITY COLLABORATIVES. Each entity that...

Section 539.0051. Plan Required for Certain Community Collaboratives - Sec. 539.0051. PLAN REQUIRED FOR CERTAIN COMMUNITY COLLABORATIVES. (a) The...

Section 539.006. Annual Review of Outcome Measures - Sec. 539.006. ANNUAL REVIEW OF OUTCOME MEASURES. The department shall...

Section 539.007. Reduction and Cessation of Funding - Sec. 539.007. REDUCTION AND CESSATION OF FUNDING. The department shall...

Section 539.008. Rules - Sec. 539.008. RULES. The executive commissioner shall adopt any rules...

Section 539.009. Administrative Costs - Sec. 539.009. ADMINISTRATIVE COSTS. A reasonable amount not to exceed...

Chapter 541 - Pediatric Tele-Connectivity Resource Program for Rural Texas

Section 541.001. Definitions - Sec. 541.001. DEFINITIONS. In this chapter: (1) "Nonurban health care...

Section 541.002. Pediatric Tele-Connectivity Resource Program for Rural Texas - Sec. 541.002. PEDIATRIC TELE-CONNECTIVITY RESOURCE PROGRAM FOR RURAL TEXAS. The...

Section 541.003. Use of Grant - Sec. 541.003. USE OF GRANT. A nonurban health care facility...

Section 541.004. Selection of Grant Recipients - Sec. 541.004. SELECTION OF GRANT RECIPIENTS. (a) The commission with...

Section 541.005. Gifts, Grants, and Donations - Sec. 541.005. GIFTS, GRANTS, AND DONATIONS. (a) The commission may...

Section 541.006. Work Group - Sec. 541.006. WORK GROUP. (a) The commission may establish a...

Section 541.007. Report to Governor and Legislature - Sec. 541.007. REPORT TO GOVERNOR AND LEGISLATURE. Not later than...

Section 541.008. Rules - Sec. 541.008. RULES. The executive commissioner may adopt rules necessary...

Section 541.009. Specific Appropriation Required - Sec. 541.009. SPECIFIC APPROPRIATION REQUIRED. The commission may not spend...

<< Previous

Texas Statutes Title 4 - Executive Branch Subtitle I - Health and Human Services

Texas Statutes
Title 4 - Executive Branch
Subtitle I - Health and Human Services