Chapter 533. IMPLEMENTATION OF MEDICAID MANAGED CARE PROGRAM    


Subchapter A. GENERAL PROVISIONS
§ 533.001. DEFINITIONS
§ 533.002. PURPOSE
§ 533.0025. DELIVERY OF SERVICES
§ 533.0026. DIRECT ACCESS TO EYE HEALTH CARE SERVICES UNDER MEDICAID MANAGED CARE MODEL OR ARRANGEMENT
§ 533.0027. PROCEDURES TO ENSURE CERTAIN RECIPIENTS ARE ENROLLED IN SAME MANAGED CARE PLAN
§ 533.0028. EVALUATION OF CERTAIN STAR + PLUS MEDICAID MANAGED CARE PROGRAM SERVICES
§ 533.0029. PROMOTION AND PRINCIPLES OF PATIENT-CENTERED MEDICAL HOMES FOR RECIPIENTS
§ 533.003. CONSIDERATIONS IN AWARDING CONTRACTS
§ 533.004. MANDATORY CONTRACTS
§ 533.005. REQUIRED CONTRACT PROVISIONS
§ 533.0051. PERFORMANCE MEASURES AND INCENTIVES FOR VALUE-BASED CONTRACTS
§ 533.0052. STAR HEALTH PROGRAM: TRAUMA-INFORMED CARE TRAINING
§ 533.0053. COMPLIANCE WITH TEXAS HEALTH STEPS
§ 533.006. PROVIDER NETWORKS
§ 533.0066. PROVIDER INCENTIVES
§ 533.007. CONTRACT COMPLIANCE
§ 533.0071. ADMINISTRATION OF CONTRACTS
§ 533.0072. INTERNET POSTING OF SANCTIONS IMPOSED FOR CONTRACTUAL VIOLATIONS
§ 533.0073. MEDICAL DIRECTOR QUALIFICATIONS
§ 533.0075. RECIPIENT ENROLLMENT
§ 533.0076. LIMITATIONS ON RECIPIENT DISENROLLMENT
§ 533.008. MARKETING GUIDELINES
§ 533.009. SPECIAL DISEASE MANAGEMENT
§ 533.010. SPECIAL PROTOCOLS
§ 533.011. PUBLIC NOTICE
§ 533.012. INFORMATION FOR FRAUD CONTROL
§ 533.013. PREMIUM PAYMENT RATE DETERMINATION; REVIEW AND COMMENT
§ 533.0131. USE OF ENCOUNTER DATA IN DETERMINING PREMIUM PAYMENT RATES
§ 533.01315. REIMBURSEMENT FOR SERVICES PROVIDED OUTSIDE OF REGULAR BUSINESS HOURS
§ 533.0132. STATE TAXES
§ 533.014. PROFIT SHARING
§ 533.015. COORDINATION OF EXTERNAL OVERSIGHT ACTIVITIES
§ 533.016. PROVIDER REPORTING OF ENCOUNTER DATA
§ 533.0161. MONITORING OF PSYCHOTROPIC DRUG PRESCRIPTIONS FOR CERTAIN CHILDREN
§ 533.017. QUALIFICATIONS OF CERTIFIER OF ENCOUNTER DATA
§ 533.018. CERTIFICATION OF ENCOUNTER DATA
§ 533.019. VALUE-ADDED SERVICES
§ 533.020. MANAGED CARE ORGANIZATIONS: FISCAL SOLVENCY AND COMPLAINT SYSTEM GUIDELINES
Subchapter B. REGIONAL ADVISORY COMMITTEES
§ 533.021. APPOINTMENT
§ 533.022. COMPOSITION
§ 533.023. PRESIDING OFFICER; SUBCOMMITTEES
§ 533.024. MEETINGS
§ 533.025. POWERS AND DUTIES
§ 533.026. INFORMATION FROM COMMISSION
§ 533.027. COMPENSATION; REIMBURSEMENT
§ 533.028. OTHER LAW
§ 533.029. FUNDING
Subchapter C. STATEWIDE ADVISORY COMMITTEE
§ 533.041. APPOINTMENT AND COMPOSITION
§ 533.042. MEETINGS
§ 533.043. POWERS AND DUTIES
§ 533.044. OTHER LAW
Subchapter D. INTEGRATED CARE MANAGEMENT MODEL
§ 533.061. INTEGRATED CARE MANAGEMENT MODEL
§ 533.062. CONTRACTING FOR INTEGRATED CARE MANAGEMENT
§ 533.063. STATEWIDE INTEGRATED CARE MANAGEMENT ADVISORY COMMITTEE