In this chapter:
- (1) Notwithstanding Section 521.0001(2), "commission" means the Health and Human Services Commission or an agency operating part of the Medicaid managed care program, as appropriate.
- (2) "Health care service region" or "region" means a Medicaid managed care service area the commission delineates.
- (3) "Managed care organization" means a person that is authorized or otherwise permitted by law to arrange for or provide a managed care plan.
- (4) "Managed care plan" means a plan under which a person undertakes to provide, arrange for, pay for, or reimburse any part of the cost of any health care service. A part of the plan must consist of arranging for or providing health care services as distinguished from indemnification against the cost of those services on a prepaid basis through insurance or otherwise. The term includes a primary care case management provider network. The term does not include a plan that indemnifies a person for the cost of health care services through insurance.
- (5) "Potentially preventable event" has the meaning assigned by Section 543A.0001.
- (6) "Recipient" means a Medicaid recipient.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.