Texas Human Resources Code - Section 32.047. Prohibition Of Certain Health Care Service Providers

Legal Research Home > Texas Laws > Human Resources Code > Texas Human Resources Code - Section 32.047. Prohibition Of Certain Health Care Service Providers

§ 32.047. PROHIBITION OF CERTAIN HEALTH CARE SERVICE PROVIDERS. A person is permanently prohibited from providing or arranging to provide health care services under the medical assistance program if: (1) the person is convicted of an offense arising from a fraudulent act under the program; and (2) the person's fraudulent act results in injury to an elderly person, as defined by Section 48.002(1), a disabled person, as defined by Section 48.002(8)(A), or a person younger than 18 years of age. Added by Acts 1997, 75th Leg., ch. 1153, § 3.03, eff. Sept. 1, 1997.

Section: Previous 32.043 32.044 32.045 32.046 32.0461 32.0462 32.0463 32.047 32.048 32.049 32.050 32.051 32.052 32.053. PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE). (a) The department, as a part of the medical assistance program, shall develop and implement a program of all-inclusive care for the elderly (PACE) in accordance with Section 4802 of the Balanced Budget Act of 1997 (Pub. L. No. 105-33), as amended. The department shall provide medical assistance to a participant in the PACE program in the manner and to the extent authorized by federal law. (b) The department shall adopt rules as necessary to implement this section. In adopting rules, the department shall: (1) use the Bienvivir Senior Health Services of El Paso initiative as a model for the program; and (2) ensure that a person is not required to hold a certificate of authority as a health maintenance organization under the Texas Health Maintenance Organization Act (Chapter 20A, Vernon's Texas Insurance Code) to provide services under the PACE program. (c) The department may not contract with a person to provide services under the PACE program unless the person: (1) purchases reinsurance in an amount determined by the department that is sufficient to ensure the person's continued solvency; or (2) has the financial resources sufficient to cover expenses in the event of the person's insolvency. (d) To demonstrate sufficiency of financial resources for purposes of Subsection (c)(2), a person may use cash reserves, a letter of credit, a guarantee of a company affiliated with the person, or a combination of those arrangements. The amount of a person's financial arrangement must be at least equal to the sum of: (1) the total capitation revenue for one month; and (2) the average monthly payment of operating expenses. (e) The department, with the cooperation of the Texas Department on Aging and area agencies on aging, shall develop and implement a coordinated plan to promote PACE program sites operating under this section. The department shall adopt policies and procedures to ensure that caseworkers and any other appropriate department staff discuss the benefits of participating in the PACE program with long-term care clients. Added by Acts 2001, 77th Leg., ch. 170, § 1, eff. Sept 32.054 Next

Last modified: August 11, 2007

Court Opinions

State Laws

US Code

US Constitution

Texas Human Resources Code - Section 32.047. Prohibition Of Certain Health Care Service Providers