Sec. 1272.208. AUTHORITY OF COMMISSIONER TO ISSUE ORDER. (a) Regardless of whether a delegated entity complies with a request for corrective action under Section 1272.207, the commissioner may order a health maintenance organization with which the entity has entered into a delegation agreement to take any action the commissioner determines is necessary to ensure that the health maintenance organization is complying with this chapter, Chapter 843, 1271, or 1367, Subchapter A, Chapter 1452, or Subchapter B, Chapter 1507.
(b) Actions the commissioner may order a health maintenance organization to take under this section include:
(1) reassuming the functions delegated to the delegated entity, including claims payments for services previously provided to enrollees;
(2) temporarily or permanently ceasing assignment of new enrollees to the entity;
(3) temporarily or permanently transferring enrollees to alternative delivery systems to receive services; or
(4) terminating the delegation agreement with the entity.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Amended by:
Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.074(h), eff. September 1, 2005.
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