Texas Health & Safety Code - Section 108.0065. Powers And Duties Of Council Relating To Medicaid Managed Care
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§ 108.0065. POWERS AND DUTIES OF COUNCIL RELATING TO
MEDICAID MANAGED CARE. (a) In this section:
(1) "Commission" means the Health and Human Services
Commission.
(2) "Medicaid managed care organization" means a
managed care organization, as defined by Section 533.001,
Government Code, that is contracting with the commission to
implement the Medicaid managed care program under Chapter 533,
Government Code.
(b) The commission may direct the council to collect data
under this chapter with respect to Medicaid managed care
organizations. The council shall coordinate the collection of the
data with the collection of data for health benefit plan providers,
but with the approval of the commission may collect data in addition
to the data otherwise required of health benefit plan providers.
(c) Each Medicaid managed care organization shall provide
the data required by the council in the form required by the council
or, if the data is also being submitted to the commission or
Medicaid operating agency, in the form required by the commission
or Medicaid operating agency.
(d) Dissemination of data collected under this section is
subject to Sections 108.010, 108.011, 108.012, 108.013, 108.014,
and 108.0141.
(e) The commission shall analyze the data collected in
accordance with this section and shall use the data to:
(1) evaluate the effectiveness and efficiency of the
Medicaid managed care system;
(2) determine the extent to which Medicaid managed
care does or does not serve the needs of Medicaid recipients in this
state; and
(3) assess the cost-effectiveness of the Medicaid
managed care system in comparison to the fee-for-service system,
considering any improvement in the quality of care provided.
(f) Not later than October 1 of each even-numbered year, the
commission shall report to the governor, the lieutenant governor,
and the speaker of the house of representatives with respect to:
(1) the commission's conclusions under Subsection (e)
and any improvement made in the delivery of services under the
Medicaid managed care system since the date of the commission's
last report under this section;
(2) recommendations for implementation by the state
agencies operating the Medicaid managed care system for improvement
to the Medicaid managed care system; and
(3) any recommendations for legislation.
(g) The report made under Subsection (f) may be consolidated
with any report made under Section 108.006(a)(9).
(h) The commission, using existing funds, may contract with
an entity to comply with the requirements under Subsections (e) and
(f).
Added by Acts 1999, 76th Leg., ch. 1460, § 8.03, eff. Sept. 1,
1999.
Section: 108.0025 108.003 108.004 108.0045 108.005 108.006 108.0062 108.0065 108.007 108.008 108.0081 108.0085 108.009 108.010 108.011
Last modified: August 10, 2007
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