(a) As used in this subchapter, a managed care organization is an entity holding a certificate of authority to operate as an HMO under Insurance Code Chapter 843 (concerning Health Maintenance Organizations) and Insurance Code Chapter 1271 (concerning Benefits Provided by Health Maintenance Evidence of Coverage; Charges), or as an ANHC under Insurance Code Chapter 844 (concerning Certification of Certain Nonprofit Health Corporations).
(b) Any managed care organization or other entity providing the services specified in 42 United States Code §1396b(m)(2)(A) and participating in the State Medicaid Program or Children's Health Insurance Program (CHIP) (MCO) must comply with the requirements of Insurance Code §843.403 (concerning Minimum Net Worth) and §7.402 of this title (relating to Risk-Based Capital and Surplus Requirements for Insurers and HMOs).

Source Note: The provisions of this §11.1801 adopted to be effective August 1, 2017, 42 TexReg 2169