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Texas Statutes
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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 540. Medicaid Managed Care Program
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Subchapter F. Required Contract Provisions
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Sec. 540.0251. Applicability.
Sec. 540.0252. Accountability to State.
Sec. 540.0253. Capitation Rates.
Sec. 540.0254. Cost Information.
Sec. 540.0255. Fraud Control.
Sec. 540.0256. Recipient Outreach and Education.
Sec. 540.0257. Notice of Medicaid Certification Date.
Sec. 540.0258. Primary Care Provider Assignment.
Sec. 540.0259. Compliance with Provider Network Requirements.
Sec. 540.0260. Compliance with Provider Access Standards; Report.
Sec. 540.0261. Provider Network Sufficiency.
Sec. 540.0262. Quality Monitoring Program for Health Care Services.
Sec. 540.0263. Out-of-network Provider Usage and Reimbursement.
Sec. 540.0264. Provider Reimbursement Rate Reduction.
Sec. 540.0265. Prompt Payment of Claims.
Sec. 540.0266. Reimbursement for Certain Services Provided Outside Regular Business Hours.
Sec. 540.0267. Provider Appeals Process.
Sec. 540.0268. Assistance Resolving Recipient and Provider Issues.
Sec. 540.0269. Use of Advanced Practice Registered Nurses and Physician Assistants.
Sec. 540.0270. Medical Director Availability.
Sec. 540.0271. Personnel Required in Certain Service Regions.
Sec. 540.0272. Certain Services Permitted in Lieu of Other Mental Health Or Substance Use Disorder Services; Annual Report.
Sec. 540.0273. Outpatient Pharmacy Benefit Plan.
Sec. 540.0274. Pharmacy Benefit Plan: Rebates and Receipt of Confidential Information Prohibited.
Sec. 540.0275. Pharmacy Benefit Plan: Certain Pharmacy Benefits for Sex Offenders Prohibited.
Sec. 540.0276. Pharmacy Benefit Plan: Recipient Selection of Pharmaceutical Services Provider.
Sec. 540.0277. Pharmacy Benefit Plan: Pharmacy Benefit Providers.
Sec. 540.0278. Pharmacy Benefit Plan: Prompt Payment of Pharmacy Benefit Claims.
Sec. 540.0279. Pharmacy Benefit Plan: Maximum Allowable Cost Price and List for Pharmacy Benefits.
Sec. 540.0280. Pharmacy Benefit Plan: Pharmacy Benefits for Child Enrolled in Star Kids Managed Care Program.