Sec. 533.0072. INTERNET POSTING OF SANCTIONS IMPOSED FOR CONTRACTUAL VIOLATIONS    


Latest version.
  • (a) The commission shall prepare and maintain a record of each enforcement action initiated by the commission that results in a sanction, including a penalty, being imposed against a managed care organization for failure to comply with the terms of a contract to provide health care services to recipients through a managed care plan issued by the organization.

    (b) The record must include:

    (1) the name and address of the organization;

    (2) a description of the contractual obligation the organization failed to meet;

    (3) the date of determination of noncompliance;

    (4) the date the sanction was imposed;

    (5) the maximum sanction that may be imposed under the contract for the violation; and

    (6) the actual sanction imposed against the organization.

    (c) The commission shall post and maintain the records required by this section on the commission's Internet website in English and Spanish. The records must be posted in a format that is readily accessible to and understandable by a member of the public. The commission shall update the list of records on the website at least quarterly.

    (d) The commission may not post information under this section that relates to a sanction while the sanction is the subject of an administrative appeal or judicial review.

    (e) A record prepared under this section may not include information that is excepted from disclosure under Chapter 552.

    (f) The executive commissioner shall adopt rules as necessary to implement this section.

Added by Acts 2005, 79th Leg., Ch. 349 , Sec. 6(b), eff. September 1, 2005.