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Current as of January 01, 2024 | Updated by FindLaw Staff
The commission shall establish and implement a process for the direct monitoring of a Medicaid managed care organization's provider network and providers in the network. The process:
(1) must be used to ensure compliance with contractual obligations related to:
(A) the number of providers accepting new patients under the Medicaid managed care program; and
(B) the length of time a recipient must wait between scheduling an appointment with a provider and receiving treatment from the provider;
(2) may use reasonable methods to ensure compliance with contractual obligations, including telephone calls made at random times without notice to assess the availability of providers and services to new and existing recipients; and
(3) may be implemented directly by the commission or through a contractor. (Gov. Code, Sec. 533.007(l).)
Cite this article: FindLaw.com - Texas Government Code - GOV'T § 540.0601. Monitoring of Provider Networks - last updated January 01, 2024 | https://codes.findlaw.com/tx/government-code/gov-t-sect-540-0601/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
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