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Texas Statutes (Last Updated: January 4, 2014) |
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GOVERNMENT CODE |
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Title 4. EXECUTIVE BRANCH |
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Subtitle I. HEALTH AND HUMAN SERVICES |
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Chapter 533. IMPLEMENTATION OF MEDICAID MANAGED CARE PROGRAM |
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Subchapter A. GENERAL PROVISIONS |
Sec. 533.017. QUALIFICATIONS OF CERTIFIER OF ENCOUNTER DATA
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(a) The person acting as the state Medicaid director shall appoint a person as the certifier of encounter data.
(b) The certifier of encounter data must have:
(1) demonstrated expertise in estimating premium payment rates paid to a managed care organization under a managed care plan; and
(2) access to actuarial expertise, including expertise in estimating premium payment rates paid to a managed care organization under a managed care plan.
(c) A person may not be appointed under this section as the certifier of encounter data if the person participated with the commission in developing premium payment rates for managed care organizations under managed care plans in this state during the three-year period before the date the certifier is appointed.