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Current as of January 01, 2024 | Updated by Findlaw Staff
(a) A contract to which this subchapter applies must require that the contracting Medicaid managed care organization not implement a significant, nonnegotiated, across-the-board provider reimbursement rate reduction unless:
(1) subject to Subsection (b), the organization has the commission's prior approval to implement the reduction; or
(2) the rate reduction is based on changes to the Medicaid fee schedule or cost containment initiatives the commission implements.
(b) A provider reimbursement rate reduction a Medicaid managed care organization proposes is considered to have received the commission's prior approval unless the commission issues a written statement of disapproval not later than the 45th day after the date the commission receives notice of the proposed rate reduction from the organization. (Gov. Code, Secs. 533.005(a)(25), (a-3).)
Cite this article: FindLaw.com - Texas Government Code - GOV'T § 540.0264. Provider Reimbursement Rate Reduction - last updated January 01, 2024 | https://codes.findlaw.com/tx/government-code/gov-t-sect-540-0264/
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