Text of section effective on April 01, 2025
Sec. 540.0054.  PROVIDER AND RECIPIENT EDUCATION PROGRAMS.  (a)  In adopting rules to implement a Medicaid managed care program, the executive commissioner shall establish guidelines for, and require Medicaid managed care organizations to provide, education programs for providers and recipients using a variety of techniques and media.
(b)  A provider education program must include information on:
(1)  Medicaid policies, procedures, eligibility standards, and benefits;
(2)  recipients' specific problems and needs; and
(3)  recipients' rights and responsibilities under the bill of rights and the bill of responsibilities prescribed by Section 532.0301.
(c)  A recipient education program must present information in a manner that is easy to understand.  A program must include information on:
(1)  a recipient's rights and responsibilities under the bill of rights and the bill of responsibilities prescribed by Section 532.0301;
(2)  how to access health care services;
(3)  how to access complaint procedures and the recipient's right to bypass the Medicaid managed care organization's internal complaint system and use the notice and appeal procedures otherwise required by Medicaid;
(4)  Medicaid policies, procedures, eligibility standards, and benefits;
(5)  the Medicaid managed care organization's policies and procedures; and
(6)  the importance of prevention, early intervention, and appropriate use of services.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.