Required Contract Provisions | Midpage

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Texas Statutes

Subchapter F

Required Contract Provisions

540.0251Applicability 540.0252Accountability to State 540.0253Capitation Rates 540.0254Cost Information 540.0255Fraud Control 540.0256Recipient Outreach and Education 540.0257Notice of Medicaid Certification Date 540.0258Primary Care Provider Assignment 540.0259Compliance with Provider Network Requirements 540.0260Compliance with Provider Access Standards; Report 540.0261Provider Network Sufficiency 540.0262Quality Monitoring Program for Health Care Services 540.0263Out-of-network Provider Usage and Reimbursement 540.0264Provider Reimbursement Rate Reduction 540.0265Prompt Payment of Claims 540.0266Reimbursement for Certain Services Provided Outside Regular Business Hours 540.0267Provider Appeals Process 540.0268Assistance Resolving Recipient and Provider Issues 540.0269Use of Advanced Practice Registered Nurses and Physician Assistants 540.0270Medical Director Availability 540.0271Personnel Required in Certain Service Regions 540.0272Certain Services Permitted in Lieu of State Medicaid Plan Services; Annual Report 540.02721Pilot Program to Provide Additional Nutrition Support Services to Certain Pregnant Recipients in Lieu of State Medicaid Plan Services 540.0273Outpatient Pharmacy Benefit Plan 540.0274Pharmacy Benefit Plan: Rebates and Receipt of Confidential Information Prohibited 540.0275Pharmacy Benefit Plan: Certain Pharmacy Benefits for Sex Offenders Prohibited 540.0276Pharmacy Benefit Plan: Recipient Selection of Pharmaceutical Services Provider 540.0277Pharmacy Benefit Plan: Pharmacy Benefit Providers 540.0278Pharmacy Benefit Plan: Prompt Payment of Pharmacy Benefit Claims 540.0279Pharmacy Benefit Plan: Maximum Allowable Cost Price and List for Pharmacy Benefits 540.0280Pharmacy Benefit Plan: Pharmacy Benefits for Child Enrolled in Star Kids Managed Care Program 540.0283Nursing Facility Provider Agreements: Compliance with Patient Care Expense Ratio